Experience with a new ultralow-profile osteosynthesis system for fractures of the metacarpals and phalanges.

Current osteosynthesis systems for the hand generally recommend thicker plates for metacarpal than for phalangeal fractures. We report a prospective review of 20 hand fractures treated with a new plating system in which 0.6-mm-profile-height plates are used for both metacarpals (11 cases) and phalanges (9 cases). After a follow-up period ranging from 6 to 24 months, there were 8 excellent, 7 good, and 2 poor results (American Society for Surgery of the Hand criteria), with no incidence of plate failure. These outcomes were compared with a matched cohort of 20 similar fractures treated with the widely used Stryker-Leibinger system. We found no significant differences in ranges of motion or complications between the 2 groups. The new plating system was technically straightforward to use and equally effective. Use of the thinner microplates for metacarpal fractures was not associated with any untoward outcomes.