Mini Plate Versus K-Wire Fixation For The Management Of Metacarpal Shaft Fracture

Abstract

Background: Metacarpal (MC) fractures are very common fracture in an orthopaedic trauma unit. Although there are many methods of treatment of metacarpal fracture, no consensus has been established regarding the best fixation technique for metacarpal fractures. Objective: Compare the clinical outcome of K-wire and Mini-plate fixation for metacarpal shaft fracture. Methods: This prospective comparative study was conducted in the Department of Orthopaedic surgery at BMU, Dhaka, from January 2023 to March 2025. A total of 28 patients were enrolled and randomly assigned to two groups: K- wire fixation (Group A) and Mini-plate fixation (Group B). Evaluations were performed before and at two, four, six, twelve weeks and six months after surgery. Clinical outcomes were measured through Total Active Motion (TAM), Quick Disabilities of the Arm, Shoulder, and Hand (Quick DASH), Visual Analog Scale (VAS) score. Data analysis utilized the ‘Statistical Package for Social Science’ version 26, with a significance threshold set at p-value <0.05. Result: The demographic and pre-operative characteristics were similar between the groups. Group A had a significantly shorter operative duration than Group B (23.57±7.57 vs. 41.79 ±8.23 min, p=0.001). Group B achieved bony union significantly sooner than Group A (7.86 ± 1.03 vs. 8.14 ± 1.66 weeks, p=0.044). Group B consistently showed significantly better VAS scores than Group A (0.71 ±0.73 vs. 1.50 ±0.86, p=0.027). At 12 weeks follow-up, Group B's Quick DASH score was significantly better than that of Group A (7.79 ±3.55 vs. 11.53 ±5.66, p=0.039). Group B's TAM was also significantly better than Group A's at 12 weeks follow-up (246.43 ±14.60° vs. 231.43 ±18.34°, p=0.024). According to the Quick DASH score, an excellent outcome was achieved in 50% of cases in Group A compared to 71.4% in Group B, while a good outcome was observed in 50% of Group A cases and 28.6% in Group B (p=0.053). Conclusion: Mini-plate fixation demonstrated superior clinical outcomes compared to K-wire fixation.