Luke P Robinson1,2, Michael P Gaspar3, Adam B Strohl2, Seth L Teplitsky4, Shiv D Gandhi5, Patrick M Kane2, A Lee Osterman2. 1. Louisville Arm and Hand, Louisville, KY, 40202, USA. 2. Department of Orthopedic Surgery, The Philadelphia Hand to Shoulder Center, P.C., Thomas Jefferson University, The Franklin, Suite G114, 834 Chestnut Street, Philadelphia, PA, 19107, USA. 3. Department of Orthopedic Surgery, The Philadelphia Hand to Shoulder Center, P.C., Thomas Jefferson University, The Franklin, Suite G114, 834 Chestnut Street, Philadelphia, PA, 19107, USA. michaelpgaspar@gmail.com. 4. Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, 19107, USA. 5. Lewis Katz School of Medicine, Temple University, Philadelphia, PA, 19140, USA.
Abstract
INTRODUCTION: Unstable proximal phalanx fractures are relatively common injuries but consensus of standard treatment is lacking. Outcomes following plate fixation are highly variable, and it remains unclear which factors are predictive for poorer results. The purpose of this study was to compare dorsal and lateral plate fixation of finger proximal phalangeal fractures with regard to factors that influence the outcome. MATERIALS AND METHODS: A retrospective chart review of proximal phalanx fractures treated with dorsal and lateral plating over a 6-year study interval was performed. Demographic data and injury-specific factors were obtained from review of clinic and therapy notes of 42 patients. Fractures were classified based on the OTA classification using preoperative radiographs. Outcomes investigated included final range of motion (ROM) and total active motion (TAM) of all finger joints. Complications and revision surgeries were also analyzed. RESULTS: Fracture comminution, dorsal and a lateral plate position, occupational therapy, and demographic factors did not significantly influence the outcome, complication, and revision rate after plate fixation of finger proximal phalangeal fractures. CONCLUSIONS: Based on the results of this study, no differences in the outcome of finger proximal phalangeal fractures treated by both dorsal and lateral plate fixation were observed. LEVEL OF EVIDENCE: Therapeutic, retrospective comparative, level III.
INTRODUCTION: Unstable proximal phalanx fractures are relatively common injuries but consensus of standard treatment is lacking. Outcomes following plate fixation are highly variable, and it remains unclear which factors are predictive for poorer results. The purpose of this study was to compare dorsal and lateral plate fixation of finger proximal phalangeal fractures with regard to factors that influence the outcome. MATERIALS AND METHODS: A retrospective chart review of proximal phalanx fractures treated with dorsal and lateral plating over a 6-year study interval was performed. Demographic data and injury-specific factors were obtained from review of clinic and therapy notes of 42 patients. Fractures were classified based on the OTA classification using preoperative radiographs. Outcomes investigated included final range of motion (ROM) and total active motion (TAM) of all finger joints. Complications and revision surgeries were also analyzed. RESULTS: Fracture comminution, dorsal and a lateral plate position, occupational therapy, and demographic factors did not significantly influence the outcome, complication, and revision rate after plate fixation of finger proximal phalangeal fractures. CONCLUSIONS: Based on the results of this study, no differences in the outcome of finger proximal phalangeal fractures treated by both dorsal and lateral plate fixation were observed. LEVEL OF EVIDENCE: Therapeutic, retrospective comparative, level III.