Comparison of the clinical efficacy of close reduction internal fixation with intramedullary pin and cross Kirschner wires for the treatment of metacarpal neck fractures

Abstract

Objective To compare the clinical efficacy of close reduction internal fixation with intramedullary pin and cross Kirschner wires in the treatment of metacarpal neck fractures. Methods From March 2013 to March 2016, 85 cases of metacarpal neck fractures were treated in our hospital. Close reduction internal fixation with intramedullary pin was conducted in 49 cases (intramedullary pin group) and with cross Kirschner wires in 36 cases (Kirschner wire group). Both groups were performed by the same surgeon. After the operation the same functional exercise instruction was given. The hand function was evaluated by the TAFS system issued by American Hand Surgery Association 10 months after the operation. Results All the patients were follow-up for 10 to 16 months with an average of 12 months. The fracture healing time was 10 weeks in one case from each of the two groups, and 6 to 8 weeks in the other 83 cases. The average healing time was (6. 2 +2. 4) weeks from the intramedullary pin group and (6. 3 +1. 9) weeks from the Kirschner wire group. There was no significant difference in the healing time between the two groups (P>0. 05). TAFS scores of hand function were excellent in 39 cases, good in 7 cases, fair in 3 cases with the excellent and good rate being 93. 9% from the intramedullary pin group; while they were excellent in 16 cases, good in 14 cases, fair in 6 cases with the excellent and good rate being 83. 3% from the Kirschner wire group 10 months after the operation. The results from the intramedullary pin group were better than those from the Kirschner wire group. The difference was statistically significant (P<0. 05). Conclusion The close reduction internal fixation with intramedullary pin for the treatment of metacarpal neck fractures is a simple method with small trauma. It has little effect on hand function exercise after the operation. The score of hand function recovery is better than that of Kirschner wire group. Key words: Metacarpal bones; Fractures,bone; Fracture fixation, internal; Intramedullary pin; Cross Kirschner wires