Internal fixation with the low profile plate system compared with Kirschner wire fixation: clinical results of treatment for metacarpal and phalangeal fractures.

A total of 71 patients with 78 metacarpal or phalangeal fractures were treated using one of two different methods of fixation. Thirty-nine fingers were treated using a low profile plate and screw system (LPP group), whereas 39 fingers were treated using Kirschner wire (K-wire group). In the LPP group, three cases of screw breakage were recorded. The LPP group required use of a splint for 0.9 weeks, significantly less than the 4.4 weeks of the K-wire group. The mean of 2.6 +/- 1.6 months for the time to union in the LPP group was significantly greater than the 1.6 +/- 0.6 months in the K-wire group. There were no instances of non-union in both groups, but one delayed union was observed in the LPP group. Total active flexion was 235 degrees and 243 degrees in the LPP and the K-wire groups, respectively. Total extension loss was 12 degrees and 9 degrees in the LPP and the K-wire groups, respectively. Although use of either method resulted in a good range of motion, LPP fixation required a much shorter time with a splint. However, because of the possibility of screw breakage, we have to exercise caution with post-operative treatment.