Dorsal Versus Lateral Plating Approach to Proximal Phalanx Fractures: A Systematic Review and Meta-Analysis

Background: Fractures of the proximal phalanx are common hand injuries. Fracture plating is used to achieve anatomical alignment and stable fixation. Dorsal plating is the standard practice; however, it can be associated with complications due to scarring around the extensor tendon. Lateral plating is gaining popularity due its extensor sparing approach. This study is a systematic review and meta-analysis that aims to compare the outcomes of the 2 approaches. Methods: MEDLINE, EMBASE, Cochrane, and PubMed databases were searched. Data relevant to total active motion, complications, Disability of the Arm, Shoulder and Hand scores, and grip strength were extracted. Results: Seven studies were included. Total active motion was significantly greater in the lateral plating approach with a mean difference of 16.03°. Complication rates in the dorsal approach were 1.52 times higher. Grip strength was higher and Disability of the Arm, Shoulder and Hand scores were lower in the lateral plating group. Conclusion: This study demonstrates evidence favoring the lateral plating approach when fixing proximal phalanx fractures.