K-Wires versus Mini-Plates Fixation in Closed Diaphysal Metacarpal Fractures

Document Type : Original Article

Authors

1 Department of Orthopedic, Surgery, Faculty of Medicine, Zagazig University, Egypt

2 Department of Orthopedic, Surgery, Faculty of Medicine, Sabha University, Libya

Abstract

Background: Closed reduction and percutaneous fixation with K-wires is one of the therapeutic choices for these unstable fractures, although they provide a less firm fixation and are rotationally unstable, as well as a higher risk of pin tract infection and problems from the protruding ends of the wires, despite offering functional results that are comparable to those of plate and screw fixation. This study aimed to compare the outcomes in terms of radiology, function, and postoperative complications for both of these surgical procedures used to repair closed metacarpal shaft fractures. Patients and methods: The current study is prospective cohort study included 36 patients suffering from metacarpal fracture. Patients were allocated randomly into 2 groups according to fixation methods; Group (I) 18 patients: were fixed with closed reduction and percutaneous intramedullary K-wires, Group (II) 18 patients: were fixed with mini-plates and screws. The times of (operation, union and the immobilization after surgery) were assessed. All the fractures were evaluated both clinically using the American Society for Surgery of the Hand Total Active Motion, Total Active Flexion and the quick DASH scores, and radio logically using three views of the hand at each visit. The follow up period 3 months. Results: Comparison of time till union, total- active motion, total active flexion and quick DASH score revealed no statistically significant difference between the 2 techniques. Conclusion: Treatment options for unstable metacarpal fractures that offer reduction and fixation include percutaneous intramedullary K-wires and open reduction internal fixation with mini-plates and screws.

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