Biodegradable Plates Versus Titanium Mini-Plates for Fixation of Metacarpal and Phalangeal Fractures

Hassan, Khaled M; Mohamed, Ahmed M; Eissa, Hesham A

doi:10.21608/ejprs.2020.68224

Biodegradable Plates Versus Titanium Mini-Plates for Fixation of Metacarpal and Phalangeal Fractures

Document Type : Original Article

Authors

The Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Minia University, Egypt

10.21608/ejprs.2020.68224

Abstract

Background: Metacarpal and phalangeal bones are prone
to injury in daily work and life and hand fractures account
for about 1.5% of all emergency room visits. Problems associated
with those fractures relate to shortening, rotation, and
dorsal apex angulation. If closed methods of treatment fail to
achieve or maintain reduction, surgery could be used. Oblique
and spiral fractures are prone to mal-rotation so operative
fixation could be necessary. Commonly used surgical techniques
are Kirschner-wire, miniplate, and screw fixations.
Biodegradable materials such as Polyglycolic acid (PGA) and
Poly-L-lactic acid (PLA) implants have been widely used for
hand fracture fixation including pins, rods, screws and plates.
Patients and Methods: In this study, we compare the
results of fixation of metacarpal fractures by titanium metal
plates (group A) with the results of biodegradable plates
(group B). This study involved twenty patients who presented
with metacarpal and phalangeal fractures who presented to
the Plastic Surgery Department of Minia University Hospital
between March 2016 and December 2016. Surgical procedure
was performed under local intravenous or general anaesthesia.
We followed cases for 6 months postoperatively.
Results: Mean age = 38.9±14.9 and 35.7±13.1 years old
for group A and B respectively. 13 patients were males and
7 were female. Operative time in group A was 55±19.4 minutes
while in group B, it was 84.5±21.2 minutes. In group A, total
range of motion was 234±15.05 degrees while in group B, it
was 133±17.02 degrees as measured by goniometer. In group
A, time for union was 7.5±1.7 weeks while in group B,
unfortunately no union occurred. In group A, one case (10%
of cases) was complicated with delayed union and another
case of infection (10% of cases), while in group B all cases
were complicated with non-union and fracture displacement
which forced us to replace with K-wire fixation.
Conclusion: In this series of metacarpal and phalangeal
fractures treated with titanium or biodegradable plates and
screws, titanium plates (group A) showed more favorable
outcomes. The stable bony construct achievable by using
titanium plates and screws (group A) is the key to good
functional results compared with the bad results using biodegradable
plates and screws (group B). Further studies are
required.
Disclosure: The authors have no financial interest to
declare in relation to the content of this articl

Keywords

Main Subjects

Hand and Upper Limb Surgery'

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