Miniplate Versus k Wires in Management of Metacarpal Fracture

Fractures of the carpals, metacarpals and phalanges account for approximately 15-19% of fractures in adults, with 59% of these occurring in the phalanges, 33% in the metacarpals and 8% in the carpal bones \[1\]. The single most common fracture site in the hand is the sub capital region of the fifth metacarpal bone (boxer's fracture) \[2\], which usually results from a direct blow to the metacarpal head \[3\]. Most hand fractures are caused by accidental falls or other sports-related injuries \[4\]. Hand fractures are among the most common fractures of upper extremity \[5, 6\]. Hand fractures can be treated conservatively or surgically, depending on the severity, location and type of fracture. The main objective of both operative and non-operative treatments is to provide fracture stability for early mobilization \[7\]. Surgical fixation is mainly indicated for displaced fractures because casts are often not sufficient to maintain reduction \[8\]. Open reduction with internal fixation (ORIF), using pins or plates, has historically been used to stabilize hand fractures which have rotational deformity or lateral angulation \[9\]. Open reduction may result in scarring, joint stiffness and tendon adhesion \[7\]. Closed reduction with internal fixation (CRIF), using percutaneous K wire or screws, is now used to treat the majority of unstable closed simple hand fractures \[10\]. It is generally considered percutaneous Kirschner wire (K wire) fixation may not provide adequate stabilization to allow for early mobilization \[8\] .