Comparison of Miniplate and K-wire in Treatment of Metacarpal and Phalangeal Fractures
Abstract
Background: The most effective method for fixation of metacarpal and phalangeal fractures has notbeen established. Two commonly used surgical techniques are K-wire and miniplate fixations. We performed
a prospective randomized trial to compare these two treatment strategies.
Materials and Methods: A total of 112 patients with 122 metacarpal and phalangeal fractures were
recruited into this study. The patients were randomized to receive fracture fixation with one of the two methods.
The operative time, pain scale, success of union, time of union, total active range of motion (ROM), total active
motion (TAM) and complications were assessed.
Results: Sixty-three fractures were treated with K-wire fixation and the rest were treated with miniplate
fixation. The K-wire group was associated with significantly shorter operative time (P<0.01). There were no
differences in postoperative pain, rate of union, healing time of the successful case, total active ROM, TAM and
complications.
Conclusion: The K-wire technique has similar effective results compared to the miniplate technique in
the treatment of metacarpal and phalangeal fracture with a shorter operative time.
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fatique strengths and stabilities of metacarpal internal fixation
techniques. J Hand Surg 1993;18:1059-68.
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comparison of metacarpal fracture stability with five different
methods of internal fixation. J Hand Surg 1985;10:1024-8.
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strengths of internal fixation techniques. J Hand Surg
1984;9:216-21.
17. Greene TL, Noellert RC, Belsole RJ, et al. Composite wiring
of metacarpal and phalangeal fractures. J Hand Surg
1989;14:665-9.
18. Dabezies EJ, Schutte JP. Fixation of metacarpal and
phalangeal fracture with miniature plates and screws. J
Hand Surg 1986;11:283-8.
19. Fyfe IS, Mason S. The mechanical stability of internal fixation
of fractured phalanges. Hand 1979;11:50-4.
20. Massengill JE, Alexander H, Lagrana N, Mylod A. Phalangeal
fracture model-quantitative analysis of rigidity and failure. J
Hand Surg 1982;17:264-70.
50.
2. Packer GJ. Shaheen MA. Patterns of hand fractures and
dislocations in a district general hospital. J Hand Surg 1993;
18:511-4.
3. Black DM, Mann RJ, Constine RM, et al. Comparison of
internal fixation techniques in metacarpal fracture. J Hand
Surg 1985;10:466-72.
4. Clinical assessment committee, American society surgery
of the hand: Report, February, 1976.
5. James JIP. Fractures of the proximal and middle phalanges
of the finger. Acta Orthop Scand 32:401-12.
6. Green DP, Anderson JR. Closed reduction and percutaneous
pin fixation of fractured phalanges, J Bone J Surg [Am]
1973;55:1651-4.
7. Duncan NJ, Kettlecamp DB. Loe-velocity wounds of the
hand. Arch Surg 1974;109:395-7.
8. Barton NJ. Fractures of the shafts of the phalanges of the
hand. Hand 1979;11:119-33.
9. Huffaker WH, Wray RC, Weeks PM. Factors influence final
range of motion in the fingers of the hand. Reconstr Surg
1979;63:82-7.
10. Strickland JW, Steichen JB, Kleinman WB, et al. Phalangeal
fractures:factor influencing digital performance. Orthop
Rev 1982;9:39-50.
11. Lister G. Intraosseous wiring of the digital skeletal. Hand Surg
1978;3:427-35.
12. Belsky MR, Eaton RG, Lane LB. Closed reduction and internal
fixation of proximal phalangeal fractures. J Hand Surg
1984;9A:725-9.
13. Firoozbakhsh KK, Moneim MS, Howey T, et al. Comparative
fatique strengths and stabilities of metacarpal internal fixation
techniques. J Hand Surg 1993;18:1059-68.
14. Mann RJ, Black D, Constine R, et al. A quantitative
comparison of metacarpal fracture stability with five different
methods of internal fixation. J Hand Surg 1985;10:1024-8.
15. Matloub HS, Jensen PL, Sanger JR, et al. Spiral fracture
fixation techniques. A biomechanical study. J hand Surg
1993;18:515-9.
16. Vanik RK, Weber RC, Matloub HS, et al. The comparative
strengths of internal fixation techniques. J Hand Surg
1984;9:216-21.
17. Greene TL, Noellert RC, Belsole RJ, et al. Composite wiring
of metacarpal and phalangeal fractures. J Hand Surg
1989;14:665-9.
18. Dabezies EJ, Schutte JP. Fixation of metacarpal and
phalangeal fracture with miniature plates and screws. J
Hand Surg 1986;11:283-8.
19. Fyfe IS, Mason S. The mechanical stability of internal fixation
of fractured phalanges. Hand 1979;11:50-4.
20. Massengill JE, Alexander H, Lagrana N, Mylod A. Phalangeal
fracture model-quantitative analysis of rigidity and failure. J
Hand Surg 1982;17:264-70.
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Published
2009-06-30
How to Cite
1.
Wutphiriya-angkul S. Comparison of Miniplate and K-wire in Treatment of Metacarpal and Phalangeal Fractures. Thai J Surg [Internet]. 2009 Jun. 30 [cited 2024 Nov. 23];30(1-2). Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/227656
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