Functional Outcome after Surgical Fixation of Metacarpal and Phalangeal Fractures using K Wire

Abstract

Background: Metacarpal and phalangeal fractures are commonly encountered fractures, majority of them are stable and can be treated by non-operative means, however, unstable fractures i.e. those with shortening, displacement, angulation, rotational deformity or segmental fractures need surgical intervention. This prospective study was undertaken to evaluate the functional outcome after surgical stabilization of these fractures by K-wire using different techniques. Materials and Methods: A prospective study was conducted between December 2010 and October 2012. Seventeen patients with 21 unstable metacarpal and phalangeal fractures were treated by surgical stabilization using K-wire with different  techniques. Fractures of the thumb and distal phalanx were excluded. All the patients were followed up for a minimum of three months. They were assessed  radiologically and clinically. The evaluation of the functional outcome was measured according to Belsky's criteria. Results: All fractures achieved union with a mean of 8.5 weeks, no delayed union or nonunion or infection was reported, but stiffness has happened in 4(19%) fractures and mal-union in 2(10%) cases. Overall functional results were excellent  to good in 17(81%) of cases and fair to poor in 4(19%) of cases .A better functional outcome was achieved in metacarpal fractures with excellent - good in (85%) as compared with phalangeal fractures with good results in (75%), Closed fractures (93%) excellent - good as compared to compound fractures with (50%) good results. Conclusion:  K-wire is a sound method of fixation for unstable metacarpal and phalangeal fractures that could give good results, regarding fracture union, functional outcome, with low complication rate. Metacarpal and closed fractures show a better functional outcome than phalangeal& compound fractures.