Internal fixation of metacarpal and phalangeal fractures with AO minifragment screws and plates: a prospective study.

In a prospective study, 43 patients with 47 metacarpal or phalangeal fractures with significant displacement, rotation, angulation and/or instability were treated with internal fixation using AO minifragment screws and plates. In all fractures an anatomical reduction was achieved. Postoperatively all metacarpal fractures were protected by means of a plaster, in which motion was allowed, whereas all phalangeal fractures were treated by means of a soft bandage. At a review after a mean period of 28 months, 31 patients with 35 fractures out of 34 patients with 38 fractures had regained excellent recovery of total active flexion (92 per cent). Three patients had a poor recovery of total active flexion; one had an infection, the other two were operated on 6 and 14 days after their injury, whereas the mean delay between injury and operation was 3 days. All patients not reviewed had regained good or 100 per cent function.