Comparative analysis of the effects of AO mini-plate and Kirschner wire pinning in the metacarpal fractures

Abstract

The aim of this study was to investigate the clinical effect of AO miniplate screw internal fixation and Kirschner wire (KW) in the treatment of metacarpal fractures. We retrospectively analyzed the clinical data of 590 metacarpal fracture patients admitted to our hospital from March 2016 to March 2019. Among them, 290 patients were treated with KWs; 300 were treated with AO microplate internal fixation. The clinical, radiological results, time of surgery, and complications were observed and compared between the 2 groups. The imaging characteristics and preoperative fracture types of the 2 groups were similar and comparable ( P > .05). The operation time, length of hospital stay, and fracture healing time of AO group were shorter than those of KW group, and the differences were statistically significant (41.22 ± 7.23 vs 25.64 ± 6.29; 7.13 ± 2.38 vs 5.26 ± 1.71; 67.43 ± 22.01 vs 52.57 ± 17.46, P < .05). In addition, the incidence of postoperative complications in AO group was lower than that in KW group (8.3% vs 15.2%, P < .05). In terms of surgical knuckle extension, flexion, and total mobility (compared with the uninjured hand), patients in the AO plate group were significantly improved compared with patients in the KW group, and the difference was statistically significant (4 vs 10 degree; 19 vs 10 degree; 14 vs 29 degree, P < .05); The average degree of finger rotation deformity in AO plate group was significantly lower than that in KW group (1 vs 6 degree, P < .05). In terms of grip strength (compared with the healthy hand), the average grip strength of AO plate group was significantly higher than that of KW group (93% vs 83%, P < .05). Patients in the OA plate group had a lower Disabilities of the Arm, Shoulder and Hand score ( P < .05). Compared with KW fixation, AO mini-plate and screw fixation for the metacarpal fracture has a better effect, which can effectively shorten the operation time and reduce the trauma to patients. It can provide patients with better stability and realize the early movement of the palm, promote fracture healing and joint function recovery; it can reduce the incidence of postoperative complications, which has certain safety. In addition, it can effectively reduce the risk of poor finger rotation.

Kirschner Wire Fixation Versus Mini Plate Fixation in Multiple Metacarpal Shaft Fractures of Hand to Compare Early Range of Motion in Hand

“…In contrast, mini-plate fixation method is associated with less trauma and provides stable internal fixation. This technique not only facilitates the fracture's fixation but also reduces the impact on the tendon and bone joints 7,29 . In 2019, a similar study was conducted at Al-Zahraa Hospital to compare the clinical and functional outcomes of treating unstable metacarpal shaft fractures with K-wires versus mini-plate fixation.…”

“…Treatment options for these fractures include K-wire and mini plate fixation. While both maneuvers have their advantages and disadvantages, the choice between them remains a topic of debate among orthopedic surgeons [7][8] .…”

Intramedullary K-wires versus Alternate Techniques for Metacarpal Shaft and Neck Fractures: A Systematic Review and Meta-analysis

“…Finally, a study evaluating rotational alignment in miniplate versus any type of K-wire fixation for metacarpal fractures found a significant difference in finger rotation deformity when comparing the two groups (1 degree vs. 6 degrees). 33 Transverse K-wire…”

Principais intervenções cirúrgicas para fraturas dos ossos do metacarpo

“…Pode reduzir ainda a incidência de complicações pós-operatórias, apresentando ainda certa segurança. Além disso, pode reduzir efetivamente o risco de rotação inadequada dos dedos (MOON SH, et al, 2015;DREYFUSS D, et al, 2019;LV F, et al, 2021).…”