Comparative Study between Kirschner Wires and Mini-Set Plate in Management of Unstable Metacarpal Shaft Fractures

Abstract

Metacarpal fractures comprise between 18–44 % of all hand fractures. Non-thumb metacarpals account for around 88 % of all metacarpal fractures, with the fifth finger most commonly involved. This is a comparative study between Kirschner wires and mini-set plate in management of unstable metacarpal shaft fractures. This is a review article, The search was performed in MEDLINE, Embase, Pubmed and CINAHL Plus in the same date range with the following mediacl terms: “Kirschner wires; mini-set plate; unstable; metacarpal shaft; fractures.”, including articles from 2000 to 2019, K-wire fixation is simple to manipulate and without or with little damage on fracture blood supply, and has been used extensively. Since in the K-wire fixation there is no compression on the fracture, it is difficult to control the motions of the fingers. Stiffness resulting from tendon adhesions and joint contractures is the most common complication associated with hand fractures. Conversely, fractures that require mini-plate fixation but are treated without fixation or with inadequate fixation still lead to stiffness and are associated with an increased rate of nonunion and malunion. Kirschner wires are almost always used for temporary fixation and are removed after the early appearance of fracture callus on radiographs. Despite the availability of many options for fixation, percutaneous fixation using Kirschner wires is a good method for treatment of unstable ulnar four metacarpal fractures. We recommended this technique, which is more biological, technically easier, safe, cheap and rapid to perform with good functional outcome.