ÖZGÜN BARIŞ GÜNTÜRK, KUBİLAY EROL, MURAT KAYALAR, TULGAR TOROS, YUSUF GÜRBÜZ
Hand and Microsurgery - 2024;13(3):97-104
Objectives: This study aimed to evaluate the clinical and radiological outcomes of minimally invasive plate osteosynthesis (MIPO) in comminuted proximal phalangeal fractures. Methods: Minimally invasive plate osteosynthesis technique was performed in 12 patients (12 males; mean age 37,3 years; SD 7.9) with closed comminuted proximal phalangeal fractures. The patients were followed up for 13.2 months (SD 2.68). Fracture healing and reduction were assessed using standard posteroanterior and lateral X-ray films on postoperative weeks 1, 4, 8, 12 and 16 and at the final follow-up. For clinical assessment, the total range of active motion and grip strength on the injured and contralateral sides were measured. Total range of active motion (TRAM) was measured using a goniometer. Results were graded according to the Duncan score. Grip strength was measured using the JAMAR hand dynamometer. Results: All fractures were observed as united during the routine X-ray visit at 12nd week. The mean TRAM was 205.8° (SD 12.2) at the final follow-up. Based on the Duncan classification, the results were excellent for eight fingers and good for four fingers. The mean grip strength of the injured side was reduced by 22% (SD 8) in the operated hands. Conclusion: Minimally invasive plate osteosynthesis enables stable fixation in comminuted fractures when stability cannot be achieved through closed reduction and K-wire fixation. Plate fixation with minimally invasive intervention may be used for the treatment of proximal phalangeal fractures.
