Abstract

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 communicated 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.

Key words: MIPO; minimally invasive, phalanx fracture