Comparison of Miniplate and K-wire in the Treatment of Metacarpal and Phalangeal Fractures.

Introduction Metacarpal and phalangeal fractures are common upper limb fractures due to direct blows, axial loading, and torsional loading injuries. The universal goal in treating all fractures for the patient to achieve normal motion, but the ideal technique for stabilization is still debated. For internal fixation, Kirschner wires (K-wires) or miniplates can be used, and each carries certain advantages. No previous study has compared K-wire use to miniplate use in treating metacarpal and phalangeal fractures. Therefore, we conducted this randomized control trial to evaluate the outcomes of K-wire and miniplate use in treating metacarpal and phalangeal fractures. Materials and methods This randomized controlled trial was conducted in the Department of Orthopaedic Surgery, Bahawal Victoria Hospital, from February 2017 to February 2018. Seventy-five patients were included in this study and randomly assigned into two groups. One group was treated with K-wire fixation, and the other group was treated with miniplate fixation. We assessed total active motion (TAM), range of motion (ROM), duration of injury, and complication rate. Data were analyzed using IBM SPSS Statistics for Windows, Version 23.0 (Armonk, NY: IBM Corp). P values ≤ 0.05 were considered significant. Results Mean surgical time, pain scale, and time of union of K-wire treated patients was 38.63±3.64 minutes, 4.17±1.11, and 12.95±3.38 weeks, respectively. The success of the union was noted in 38 K-wire patients (95%). Total active ROM was greater in miniplate fixation patients compared with K-wire treated patients, but this difference was statistically significant. Similarly, TAM was also greater in the miniplate fixation patients compared to the K-wire treated patients, but this difference was also not statistically significant. Conclusion Both K-wire fixation and miniplate fixation are equally effective in terms of TAM, ROM, and complications when used to treat metacarpal and phalangeal fractures.