Dual Miniplate Fixation for the Comminuted Fractures of the Hand

Shin,  Heung Sub; Kim,  Hyo Kon; Ha,  Sung Han; Yu,  Sun O; Lee,  Gi Jun

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Original Article

Journal of the Korean Society for Surgery of the Hand 2011;16(2):78-84.

Dual Miniplate Fixation for the Comminuted Fractures of the Hand

Heung Sub Shin, Hyo Kon Kim, Sung Han Ha, Sun O Yu, Gi Jun Lee

Department of Orthopedic Surgery, MS Jaegeon Hospital, Daegu, Korea. leegjos@paran.com

Abstract

Purpose
The objective of this study was to evaluate clinical results of dual miniplate fixation for comminuted or periarticular fractures of the hand. MATERIALS AND METHODS: Twenty cases in 18 patients who had comminuted or periarticular fractures of metacarpal or phalangeal bones were treated with dual miniplate fixation from April, 2007 to May, 2009. The mean followed up period was 14.7 months. Our study included comminuted or periarticular fractures which were difficult to keep the fixation by pining or single plating. We evaluated radiologic bony union, angular or rotational deformity, extensor tendon irritaion and total arc of motion.

Results
Bony union was achieved successfully after primary dual miniplate fixationin in 12 cases. In 7 cases with a nonunion following previous operative fixation, bony union was obtained by dual miniplate fixation and bone grafting. In one case who had received primary dual plate fixation, nonunion occurred due to massive bone defect. Bony union was obtained by secondary dual plate fixation and bone grafting. Postoperative rotational deformity, angular deformity and irritation symptom were not observed in all cases. Functionally acceptable range of active motion was restored by way of early active motion.

Conclusion
The dual miniplate fixation is one of the useful method for comminuted metacarpal or phalangeal fractures which cannot obtain firm fixation by other methods.

Key Words: Hand comminuted fracture, Periarticular fracture, Dual miniplate

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