Skeletal fixation in digital replantation. Use of the "H" plate

Abstract

Many forms of bone fixation have been advocated for use in digital replantation, and successful series have been reported using such methods as intramedullary Kirschner-wire fixation, crossed Kirschner-wires, bone pegs, double-headed screws, and bone plates. Symptomatic nonunions have been rare with these various types of bone fixation. The functional results that have been reported are usually considered good; however, amputation of digits through the proximal phalanges is still a difficult area in which to obtain satisfactory function as measured by proximal interphalangeal joint motion. This may be related to a reluctance on the part of the surgeon to use early mobilization techniques for fear of disrupting marginally stabilized fractures. The "H" plate provided rigid fixation in six patients. This technique promotes earlier mobilization and shows promise of improved functional results.