Comparison of clinical and radiological results of fixation methods with retrograde intramedullary Kirschner wire and plate-screw in extra-articular metacarpal fractures
Mehmet Baydar1
, Abdurrahman Aydın2, Ayşe Şencan1, Osman Orman1, Serkan Aykut2, Kahraman Öztürk1
1Department of Orthopedics and Traumatology, Division of Hand Surgery Clinic, University of Health Sciences, Metin Sabancı Bone Diseases Training and Research Hospital, Istanbul, Turkey
2Department of Orthopedics and Traumatology, University of Health Sciences, Metin Sabancı Bone Diseases Training and Research Hospital, Istanbul, Turkey
Keywords: Hand trauma, intramedullary fixation, Kirschner wire, metacarpal fracture, plate-screw fixation
Abstract
Objectives: In this study, we aimed to compare clinical and radiographic outcomes of retrograde intramedullary Kirschner-wire (K-wire) fixation with those of plate-screw (PS) fixation.
Patients and methods: A total of 98 metacarpal shaft fractures in 75 patients (65 males, 10 females; mean age: 31.2±10.9 years; range, 16 to 65 years) were included between January 2011 and December 2017. The total joint active range of motion (AROM) and grip strength of the healthy and broken hands were evaluated. The Visual Analog Scale (VAS) and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) scores were recorded. We compared surgery duration, number of fluoroscopy images, and cost-effectiveness for each technique.
Results: The overall mean follow-up was 21.9 (range, 12 to 56) months. At the last follow-up, total joint AROM (p=0.072), VAS score (p=0.298), QuickDASH score (p=0.132), and hand grip strength (p=0.947) were similar between the groups. Radiological union occurred in the PS and K-wire groups in a mean of 5.84 (range, 3 to 8) and 4.46 (range, 3 to 20) weeks, respectively (p=0.173). A significant difference was found in surgery duration (p=0.021) and number of fluoroscopy images (p<0.05) between the PS and K-wire groups. Two wound complications were observed in the PS group and one with K-wires.
Conclusion: Retrograde intramedullary K-wire fixation has certain advantages such as being less invasive and more accessible with shorter operation time, compared to PS fixation. Similar radiological and clinical scores can be obtained in patients undergoing retrograde intramedullary K-wire fixation or PS fixation.
Citation: Baydar M, Aydın A, Şencan A, Orman O, Aykut S, Öztürk K. Comparison of clinical and radiological results of fixation methods with retrograde intramedullary Kirschner wire and plate-screw in extra-articular metacarpal fractures. Jt Dis Relat Surg 2021;32(2):397-405.
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
The authors received no financial support for the research and/or authorship of this article.