Predictors of Postoperative Finger Stiffness in Unstable Proximal Phalangeal Fractures

Screw and/or plate systems are often used for unstable finger fractures. Although plate fixation provides strong stabilization and allows earlier and more intensive digital rehabilitation, postoperative finger stiffness is more likely to occur. Several patient and fracture variables have been reported to contribute to postoperative finger stiffness, including patient age, associated soft-tissue injury, and articular and phalangeal involvement.1–7 However, how surgical variables contribute to the occurrence of postoperative finger stiffness remains unclear. Many investigators have reported that phalangeal fractures have a higher relative risk of finger stiffness because of the complex structure of the extensor mechanism.4–7 Therefore, in the present study, we only enrolled patients with proximal phalangeal fractures to assess the effects of surgical variables on finger stiffness. We hypothesized that dorsal plate placement is a risk factor for postoperative finger stiffness. The purpose of this study was to determine the risk factors for postoperative finger stiffness after open reduction and internal fixation of unstable proximal phalangeal fractures using a low-profile plate and/or screw system.