Comparative Study Between Intramedullary K Wires Versus Mini-plates and Screws in Fixation of Metacarpal Shaft Fractures in Adults

Abstract

Background: Percutaneous intramedullary K. wires fixation and mini-plates fixation are reasonable options for treating unstable metacarpal fractures as they provide anatomical reduction and rigid fixation, which is adequate to permit early mobilization. Objective: To compare between mini-plates and Kirschner wires in management of unstable metacarpal shaft fractures in adults. Patients and Methods: All patients (n=30) included in this prospective comparative study were managed and followed up at Al-Azhar University Hospital from January 2019 to February 2020. Thirty patients with fracture of shaft metacarpal were divided into 2 groups: group A (n=15) were managed by percutaneous intramedullary K-wires and group B (n=15) were managed by mini-plates. Results:27 Patients were males and 3 were females . Dominant hand affection were in 20 patients . All patients had a complete union between 4-8 weeks for group A with average of 6 weeks and 6-10 weeks for group B with average of 8 weeks. The total result according to TAF score, Quick DASH score, and handgrip was excellent in 10 cases, good in 4 cases, and fair in 1 case in group A, while group B was excellent in 10 cases, good in 3 cases, fair in 1 case and poor in 1 case. Conclusion: Both techniques are highly effective for fixation of metacarpal shaft fractures. Mini-plate fixation provides rapid recovery of hand function and K-wire fixation allows a wide range of hand motion and soft tissue preservation.