SEPTEMBER 2013 |฀Volume฀36฀•฀Number฀9 n Feature Article abstract Full article available online at Healio.com/Orthopedics. Search: 20130821-20 Certain metacarpal fracture patterns require operative fixation to restore anatomy and optimize results. Compared with dorsal plating, the width of the minicondylar blade plate buttresses the deforming volar pull of the intrinsics and provides a stronger con- struct. The implant provides firm fixation in the juxta-articular fragment with minimal space requirements. Therefore, the purpose of this study was to examine the outcomes following the use of a minicondylar blade plate for the treatment of distal metacarpal fractures. Twenty-two distal metacarpal fractures in 20 patients treated with a minicondylar blade plate were retrospectively reviewed. Outcome measures collected included postoperative grip strength, range of motion, return to work, and radiographic evi- dence of osseous union. Average range of motion of the metacarpophalangeal joint was 62° postoperatively. Eighty-two percent (18/22) of fractures were able to flex their digits to their distal palmar crease. Seventy-one percent (12/17) of patients had at least 75% return to grip strength compared with the contralateral side. Seventeen patients returned to full activity at a mean of 2.5 months (range, 1-3 months) postoperatively; 1 patient was on disability, and data were not available for the final 2 patients. No major complications occurred. The minicondylar blade plate is a safe and effective technique for stabilizing unstable periarticular metacarpal fractures. Stable fixation allows for early range of motion, rapid return to strength, and a relatively quick return to full work duty. The authors are from Philadelphia College of Osteopathic Medicine (PAS); Philadelphia Hand Center (SMJ, CLW, MR, JMB), Thomas Jefferson University, Philadelphia, Pennsylvania; and the Department of Orthopedics (JMA), University of Maryland School of Medicine, Timonium, Maryland. The authors have no relevant financial relationships to disclose. Correspondence should be addressed to: Paul A. Sibley, DO, Philadelphia College of Osteopathic Medicine, Philadelphia, PA (sibleyp@gmail.com). doi: 10.3928/01477447-20130821-20 Internal Fixation of Distal Metacarpal Fractures: New Uses for an Old Plate PAUL A. SIBLEY, DO; SIDNEY M. JACOBY, MD; JOSHUA M. ABZUG, MD; CHRISTINA L. WADDELL, PA-C; MICHAEL RIVLIN, MD; JOHN M. BEDNAR, MD Figure: Anteroposterior radiographs showing a metacarpal neck fracture preoperatively (A) and 105 days after fixation with a minicondylar blade plate (B) in 69-year-old woman. B A e1169