Plate fixation in the hand skeleton should be infrequent and should be reserved primarily for the metacarpals. Use of plates in the fingers is discouraged because of the frequent need for removal of hardware and tenolysis. However, highly comminuted fractures may require fixation with plates to allow adequate stability for early motion. For the phalanges, 1.5- and 2.0-mm plates are recommended. Their application requires an extensive exposure of the joint and precise placement of the implants (Fig. 39-5).
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