Extra Periosteal Sliding Plate, a New Surgical Technique for the Treatment of Fractures of the First Metacarpal and Proximal Phalanx

Background: One of the most important objectives when performing an open reduction of a fracture is to achieve a stable internal fixation with minimal damage of the periosteum to preserve irrigation in the fracture site and thus promote adequate healing. Minimally Invasive plate osteosynthesis (MIPO) follow this key technical point with great effectiveness and efficiency, however, a reduction technique with these characteristics for the management of hand fractures has not yet been widely described for the management of hand fractures. Methods: The authors technique proposes a new surgical technique “extra-periosteal sliding plate” fixation for first metacarpal and proximal phalanx fractures. Data are obtained from 9 patients from June 2022 to January 2023 and a threemonth postoperative follow-up is performed where functionality and rehabilitation results are evaluated. Results: In total nine patients underwent to the described technique achieving adequate fracture stability and total bone healing with favorable functional outcomes without sequelae. Conclusion: Extra-periosteal sliding plate fixation is considered a great surgical option for the management of hand fractures, specially in those patients with severe trauma in whom vascular and soft tissue integrity must be preserved, providing suitable functional outcomes.