Comparison of Frequency of Union with Percutaneous Intramedullary Kirschner Wire versus Interfragmentary Screw Fixation in Displaced Extra-articular Metacarpal Fractures

Abstract

Objective: To compare the frequency of union in cases treated with percutaneous intramedullary kirschner wire versus interfragmentary screw fixation of displaced extra-articular metacarpal fractures.

Study Design: Randomized controlled trial.

Place and Duration: The Department of Othropedic surgery, Ghurki Trust Teaching Hospital Lahore, Pakistan from May 2021 to November 2021.

Methodology: A total of 70 cases (35 in each group) of both genders aged 18-60 years with displaced extra-articular metacarpal fracture were included. Surgery was performed with the patient under peripheral anesthesia adopting pneumatic tourniquet and image intensification. Patients were randomly divided into 2 groups, undergoing either percutaneous intramedullary K-wire fixation or interfragmentary Screw Fixation. Patients were followed up till 16^th week to see the union.

Results: The mean age of patients in K-wire group was 37.89±9.34 years and in screw fixation group was 40.17±12.82 years.  In K-wire group, there were 24 (68.57%) male and 11(31.4%) female cases while in Screw fixation group there were 17 (48.6%) male and 18 (51.4%) female cases. In K-wire group, 20 (57.1%) cases reported union while in Screw fixation group, 33 (94.3%) cases reported union at the final follow up (p<0.001).

Practical Implications: Interfragmentary screw fixation in displace extra-articular metacarpal fractures yielded better outcomes.

Conclusion: Significantly more cases treated with interfragmentary screw fixation of displaced extra-articular metacarpal fractures reported union in comparison to percutaneous intramedullary kirschner wire.

Keywords: Metacarpal fractures, internal fixation, intramedullary K-wire, screw fixation, union.