Mini-plate versus Kirschner wire internal fixation for treatment of metacarpal and phalangeal fractures

Wang, Dong; Sun, Kai; Jiang, Wenxue

doi:10.1177/0300060519887264

Cited by 15 publications

(10 citation statements)

References 12 publications

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“…Time of operation was significantly lower in the antegrade IMN group. Chen and Wang stated lower timing for both groups with similar significantly lower operative timing of the intramedullary wires group [29,32].…”

Section: Discussionmentioning

confidence: 85%

Multiple Intramedullary Nailing Versus Low Profile Mini-Plating in Unstable Metacarpal Neck Fractures

Aboelnaga

Ramadan

Quolquela

et al. 2021

JAMMR

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Background: Neck fractures of the metacarpal bone can alter optimal hand function. Many surgical fixation techniques are described for this fracture with no robust evidence for the best treatment. Recently developed low profile plates may, however, challenge the preference for K-wires. Low profile plates were found to have lower complications than conventional plates in addition to early range of motion and early return to work. The aim of the present study was to determine the best outcome in patients with unstable fracture neck metacarpals using either multiple K wires or low profile mini-plating. Methods: This prospective randomized controlled study included 37 patients suffering from metacarpal neck fractures. patients were designated as group 1 (AIN group; 18 patients), and the other consecutive patients were designated as group 2 (LPP group; 19 patients). Both groups were treated within the first 48 hours of their injury and followed up for a minimum period of 40 weeks; the maximum period of follow up was 48 weeks. Results: No significant differences were found for PVAS, Q-DASH, TAM, time to radiological union or residual deformities at last follow-up. Grip strength, however, was significantly better in the K-wire group. Operative time and time off work were significantly shorter in the k-wire group. Plate group showed prevalent complications both peri and post-operative hitting 63.2 % of the plate group vs 16.7% in K-wire group. Conclusions: Low profile plates with immediate mobilization paradoxically prolonged operative time, technical demand and disturbing the fracture’s biological environment along with the extra cost were thus not justified by results. Antegrade intramedullary K-wire nailing was superior for the management of unstable metacarpal neck fractures.

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Section: Discussionmentioning

confidence: 85%

Multiple Intramedullary Nailing Versus Low Profile Mini-Plating in Unstable Metacarpal Neck Fractures

Aboelnaga

Ramadan

Quolquela

et al. 2021

JAMMR

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“…Many of surgical modalities have been applied for the treatment of these fractures but mini-plate fixation and internal fixation with K-wire are the most performing procedures due to high rate of excellent functional outcomes and fewer rates of complications. 12,13 Majority of patients were male in both groups and overall accounted 62.5% while 37.5% were females. Overall mean age in our study was 35.46±8.58 years.…”

Section: Discussionmentioning

confidence: 96%

Compare the Outcomes of Mini-Plate versus K-Wire Fixation in Patients with Shaft of Metacarpal Fractures

Noor¹,

Nasir²,

Zahra³

et al. 2021

PJMHS

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Objective: To compare the functional outcomes of K-wire versus mini plate fixation for the treatment of fractures shaft of metacarpal. Study Design: Randomized controlled trial Place and Duration of Study: Department of Orthopaedic, Sahara Medical College, Narowal from 1st August 2020 to 31st January 2021. Methodology: Fifty six patients of both genders presented with fractures shaft of metacarpal were included. Patient’s ages were ranging between 15 to 60 years. Radiographic assessment was done to all the patients. Patients were categorized in to two equal groups. 28 patients treated with mini plates (group A) and 28 patients treated with K-wire fixation (group B). Post-operative complications were examined and compare between both groups. DASH scoring system was used for analyzing functional outcomes. Results: Mean age in group A was 34.57±7.84 years and in group B it was 34.95±7.76 years. Majority of patients 18 (64.29%) and 17 (60.71%) were males in group A and B. Mean time of union in group A was 9.58±2.24 weeks while in group B it was 12.33±2.85 weeks, the difference was statistically significant (p-value <0.05). As per DASH criteria, 15 (57.14%), 11 (39.29%) and 2 (7.14%) patients had excellent, good and fair functional outcomes who treated with mini plates internal fixation, while in group B 12 (42.86%), 13 (46.43%), 2 (7.14%) and 1 (3.57%) patients had excellent, good, fair and poor functional outcomes. Postoperative complications were more in group B as compared to group A but the difference was not statistically significant (p-value >0.05). Conclusion: Both procedures mini-plate internal fixation and K-wire fixation are effective for fractures shaft of metacarpal. However, mini-plates showed better functional outcomes with fewer rate of postoperative complications and earlier union as compared to K-wire internal fixation. Keywords: Shaft of metacarpal fracture, Internal fixation, Mini-plate, K-wire, DASH scoring system

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“…31 A meta-analysis comparing miniplate internal fixation with IMKW for metacarpal and phalangeal fractures noted that using plates resulted in longer operative times than IMKW but improved fracture healing and decreased complication rates. 32 However, this meta-analysis only included studies performed in China on the Chinese population reporting the outcomes of both metacarpal and phalangeal fractures. 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).…”

Section: Discussionmentioning

confidence: 99%

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

Thomas

Kachooei

Ilyas

2023

Journal of Hand and Microsurgery

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Intramedullary K-wire (IMKW) fixation is one of the mainstays for surgically treating metacarpal shaft and neck fractures. However, there remains a lack of literature comparing outcomes of the various available surgical repair techniques in all indicated metacarpals. Therefore, we conducted a systematic review and meta-analysis to investigate the clinical advantages and drawbacks of IMKW compared with alternate fracture repair techniques. A comprehensive systematic literature review was performed to identify studies that compared clinical outcomes of IMKW to alternate metacarpal fixation modalities. Outcomes included Disabilities of the Arm, Shoulder, and Hand (DASH/quickDASH) scores, grip strength, union rate, visual analog scale pain, operative time, and complications. A random-effects model was used to compare IMKW to the pooled effect of other fixation techniques. A total of 10 studies were included in our analysis, comprising 497 metacarpal fractures (220 shafts and 277 necks). IMKW fixation was identified as the control group in all studies. The pooled experimental group included plates, transverse K-wires (TKWs), interfragmentary screws (IFSs), and K-wire cross-pinning (CP). In treating metacarpal shaft fractures, IMKW showed significantly shorter operative time (p = 0.04; mean difference = − 13; 95% confidence interval = −26 to −0.64). No significant differences were observed in treating metacarpal neck fractures for disability, grip strength, healing rate, pain, operative time, or complication rate. This systematic review and meta-analysis found no difference in clinical outcomes among various surgical techniques for treating metacarpal shaft and neck fractures. Further high evidence studies are required that investigate the efficacy and safety of IFS, CP, TKW, and intramedullary screws versus IMKW for treating closed, unstable metacarpal fractures.

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Mini-plate versus Kirschner wire internal fixation for treatment of metacarpal and phalangeal fractures

Cited by 15 publications

References 12 publications

Multiple Intramedullary Nailing Versus Low Profile Mini-Plating in Unstable Metacarpal Neck Fractures

Multiple Intramedullary Nailing Versus Low Profile Mini-Plating in Unstable Metacarpal Neck Fractures

Compare the Outcomes of Mini-Plate versus K-Wire Fixation in Patients with Shaft of Metacarpal Fractures

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

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