Predictors of the postoperative range of finger motion for comminuted periarticular metacarpal and phalangeal fractures treated with a titanium plate

Injury, 05/17/2012

Shimizu T et al. – Phalangeal fracture, increasing age and associated soft–tissue injury were important risk factors to identify the postoperative %TAM in the treatment of comminuted periarticular metacarpal or phalangeal fracture with a titanium plate.

Methods

  • Seventy–two patients (62 males, 10 females; 37±15years) with periarticular fractures involving metaphyseal comminution and displacement were evaluated at a minimum of 1year following surgery.
  • There were 49 phalangeal bone fractures, 30 intra–articular fractures and 20 associated soft–tissue injuries.
  • The locations of plate placement were lateral in 42 patients and dorsal in 30.
  • The mean duration from injury to surgery was 7.6days (range, 0–40days).
  • There were eight examined variables related to patient characteristics (age, gender and hand dominance), fracture characteristics (fracture location, joint involvement and associated soft–tissue injury) and surgical variables (location of plate placement and duration from injury to surgery).
  • Univariate and multivariate linear regression analysis were used to identify the degree to which variables affect %TAM at the final follow–up.

Results

  • Univariate analysis indicated moderate correlations of %TAM with fracture location, associated soft–tissue injury and age.
  • Multiple linear regression modelling including fracture location, age and associated soft–tissue injury resulted in formulae that could account for 46.3% of the variability in %TAM: fracture location (β=–0.388, p<0.001), age (β=–0.339, p<0.001) and associated soft–tissue injury (β=–0.296, p=0.002).

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