JAAOS - 2026-06-15 - Journal Article
Management of Metacarpal and Phalangeal Fracture Malunions.
Morrell N, Kelley NH, Pidgeon TS
Topics
Key Takeaway
Corrective osteotomy for metacarpal and phalangeal malunion can address all three planes of deformity, with 3D-printed cutting guides and software-assisted planning improving surgical precision, though specific union or functional outcome rates are not reported.
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Summary
This narrative review addresses surgical management of metacarpal and phalangeal fracture malunions, covering corrective osteotomy techniques for coronal, sagittal, and rotational deformity. The authors highlight preoperative software-assisted planning and 3D-printed cutting guides as tools that improve accuracy of complex multiplanar corrections. No pooled outcome data or specific union rates are provided.
Key Limitation
No quantitative outcome data are presented, making it impossible to compare functional recovery or complication rates between conventional and technology-assisted osteotomy techniques.
Original Abstract
Fractures of the metacarpals and phalanges are common. Inadequate management of these injuries frequently results in malunion. Although the hand is capable of adaptation to some malalignment, malunions of the metacarpals and phalanges are often functionally notable. In these cases, surgical correction may result in improved outcomes. Corrective osteotomies are capable of improving coronal, sagittal, and axial plane malalignment. Preoperative software-assisted osteotomy planning and 3D-printed cut guides are contemporary innovations that make treatment of these difficult problems much more approachable.