Outcome of Displaced Metacarpal and Proximal Phalangeal Fractures Treated with Intramedullary κ-Wire and Cross κ-wires: A Prospective Study of 105 Patients

Abstract

AIM: Kirschner wire (κ-wire) fixation is one of the most commonly used methods for fixation of metacarpal and phalangeal fractures.Two commonly used surgical techniques are intramedullary κ-wire fixation and cross κ-wires fixation. The aim of our study was to evaluate and compare the functional results and complications in closed displaced metacarpal and phalangeal fractures treated with κ-wires using above two techniques. MATERIALS AND METHODS: 105 patients of closed displaced metacarpal and phalangeal fractures were randomized to receive fracture fixation with one of the two methods, 54 patients stabilized with intramedullary κ-wires (group A) and rest 51 patients with cross κ-wires (group B). 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.The Student’s t-test was used to analyze the difference of mean for different parameters. RESULTS: Both groups showed no statistical difference in term of age (p=0.82), gender (p=0.64), the time from injury to operation (p=0.62). After surgical fixation with above two techniques, there were no significant difference found in terms of postoperative pain, rate of union, union time, total active range of motion (ROM), total active motion (TAM) and complications except postoperative loss of reduction which was found significantly more common in group A (p=0.04). There was insignificant difference found in terms of outcomes and complications between patients of both the groups treated with both techniques. CONCLUSION: Transverse and short oblique closed metacarpal and proximal phalangeal fractures treated with intramedullary κ-wire and cross κ-wires had produced favourable and comparable outcomes in long term.