Use of eight-hole titanium miniplates for unstable phalangeal fractures.

The authors present a series of 16 unstable phalangeal fractures (13 patients) treated by open reduction and internal fixation using the eight-hole titanium miniplate system from Synthes (Paoli, PA). Thirteen fractures were finger fractures whereas three were thumb fractures. Most fractures (n = 15) were crush injuries with concomitant soft tissue trauma. Six patients with finger fractures had good to excellent range of motion (total active motion > or =180). Two patients with thumb fractures had moderate range of motion (range of motion 70-97), whereas the remaining patient with thumb fracture had poor motion because the interphalangeal joint was destroyed. Complications included two cases of plate exposure because of insufficient soft tissue cover. Although no malunion occurred in this series, there was one case of delayed union. Three patients had extensor tenolysis to improve motion. The eight-hole miniplate system adds to the versatility of the many options available for fixation of unstable phalangeal fractures. Rigid fixation using this system is particularly helpful in initiating early motion in severely crushed fingers with concomitant soft tissue injury.