J Korean Fract Soc.  2022 Jan;35(1):9-15. 10.12671/jkfs.2022.35.1.9.

Minimal Invasive Fixation Methods for the Metacarpal Fracture

• Kwon KY
• Oh JR
• Kwak JW

• KMID: 2525198
• DOI: http://doi.org/10.12671/jkfs.2022.35.1.9

Abstract

Purpose
This study compared the radiologic and clinical outcomes of metacarpal fractures treated with two minimally invasive surgical techniques: Kirschner wire (K-wire) fixation and headless screw fixation.
Materials and Methods
This study included 52 patients (46 males and 6 females; age 18-55 years) with distal metacarpal fractures (middle and distal shaft, including the neck) who had undergone K-wire fixation or headless screw fixation. All subjects were followed up for at least six months. The radiologic assessments were performed to evaluate the angular deformity and shortenings. The total active motion (TAM), grip strength, and patients’ subjective functional assessment were measured to evaluate the hand function. The time taken to return to work (RTW) and adverse events were analyzed.
Results
Of the 52 cases, metacarpal fractures treated with headless screw fixation and K-wire fixation showed a significant difference associated with early RTW (p<0.05). There were no significant differences between the subjects treated with K-wire fixation and those with headless screw fixation in terms of the radiologic measurement, hand function examinations, complications, and adverse events (p>0.05).
Conclusion
After a six-month follow-up, minimally invasive K-wire fixation and headless screw fixation produced similar clinical and radiologic outcomes in subjects with metacarpal fractures. Compared to K-wire fixation, however, headless screw fixation led to earlier functional recovery and might be a better option for treating metacarpal fractures in this regard.

Keyword

Metacarpus; Metacarpal bone fracture; Percutaneous kirschner wire fixation; Intramedullary headless compression screw fixation