Hassan, K., Mohamed, A., Eissa, H. (2020). Biodegradable Plates Versus Titanium Mini-Plates for Fixation of Metacarpal and Phalangeal Fractures. The Egyptian Journal of Plastic and Reconstructive Surgery, 43(3), 581-589. doi: 10.21608/ejprs.2020.68224
Khaled M Hassan; Ahmed M Mohamed; Hesham A Eissa. "Biodegradable Plates Versus Titanium Mini-Plates for Fixation of Metacarpal and Phalangeal Fractures". The Egyptian Journal of Plastic and Reconstructive Surgery, 43, 3, 2020, 581-589. doi: 10.21608/ejprs.2020.68224
Hassan, K., Mohamed, A., Eissa, H. (2020). 'Biodegradable Plates Versus Titanium Mini-Plates for Fixation of Metacarpal and Phalangeal Fractures', The Egyptian Journal of Plastic and Reconstructive Surgery, 43(3), pp. 581-589. doi: 10.21608/ejprs.2020.68224
Hassan, K., Mohamed, A., Eissa, H. Biodegradable Plates Versus Titanium Mini-Plates for Fixation of Metacarpal and Phalangeal Fractures. The Egyptian Journal of Plastic and Reconstructive Surgery, 2020; 43(3): 581-589. doi: 10.21608/ejprs.2020.68224
Biodegradable Plates Versus Titanium Mini-Plates for Fixation of Metacarpal and Phalangeal Fractures
The Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Minia University, Egypt
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
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