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

Abstract

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