Abstract
ObjectivesThis meta-analysis aimed to compare the therapeutic effect of mini-plate versus Kirschner wire (K-wire) internal fixation on the treatment of metacarpal and phalangeal fractures among Chinese Han population.MethodsDatabases of China National Knowledge Infrastructure (CNKI), Wanfang, Chinese VIP, PubMed, and Embase were retrieved for studies on mini-plate (case group) versus K-wire (control group) internal fixation for the treatment of metacarpal and phalangeal fractures among Chinese Han population. The odds ratio (OR) and standardized mean difference (SMD) at 95% confidence interval (CI) were used for estimating the effects of dichotomous data and continuous data, respectively. All statistical analyses were performed by Review Manager 5.2 software.ResultsA total of 18 studies involving 1,375 metacarpal or phalangeal fracture patients (709 cases and 666 controls) were included in the meta-analysis. There were significant differences in fracture healing time (SMD = −1.28; 95% CI: −1.81, −0.76), postoperative infection rate (OR = 0.25; 95% CI: 0.16, 0.39), complication incidence (OR = 0.24; 95% CI: 0.15, 0.38), and surgery time (SMD = 1.57; 95% CI: 0.76, 2.37) between the case and the control group, while no significant difference was found in hospital stays between these two groups (SMD = 0.43; 95% CI: −0.34, 1.20; P = 0.27).ConclusionsFor the treatment of metacarpal or phalangeal fracture among Chinese Han population, mini-plate has advantages of shorter healing time and lower infection rate and complication incidence compared with K-wire internal fixation, while a longer surgery time than K-wire. In conclusion, mini-plate is prior than K-wire internal fixation for the treatment of metacarpal or phalangeal fracture among Chinese Han population.
Highlights
IntroductionMetacarpal and phalangeal fractures constitute 10% of all fractures [1]
Metacarpal/phalangeal are injury-prone in daily work and life
Because of the less rigid fixation with little stability of the Kirschner wire (K-wire), it is limited in the treatment of unstable fractures, while mini-plate is considered as a potential option for unstable fractures of the hand with good stability allowing early mobilization of joints and avoiding problems associated with protruding K-wire [5,6,7]
Summary
Metacarpal and phalangeal fractures constitute 10% of all fractures [1]. The metacarpal/phalangeal fractures are often treated with closed reduction with internal fixation (CRIF). CRIF has been widely used to treat the majority of unstable closed simple hand fractures [2] and has been a mainstay of treatment for most phalangeal fractures [3] since the percutaneous screws and Kirschner wire (K-wire) were introduced a method of CRIF [4]. Because of the less rigid fixation with little stability of the K-wire, it is limited in the treatment of unstable fractures, while mini-plate is considered as a potential option for unstable fractures of the hand with good stability allowing early mobilization of joints and avoiding problems associated with protruding K-wire [5,6,7]
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