Metacarpal fractures treated by percutaneous Kirschner wire

Author: Bahubali Aski and Abhinav Bhatnagar

Introduction: Metacarpals and phalanges are injury prone in daily work and life. These constitute 10% of all fractures. Although these fractures are considered minor injuries, such injuries may cause major disabilities if not taken care of. Most hand fractures can be treated by nonoperative methods with good outcome. However unstable fractures need some form of fixation. Aim of our study is to evaluate outcome of K wire fixation for unstable metacarpal shaft fractures.
Material and methods: Fourteen cases of unstable metacarpal shaft fractures were treated with closed reduction and percutaneous K wire fixation. Patients age ranged between 18 to 46 years with mean age of 27 years. Nine were male and 5 were female patients. Most cases were treated on day care basis. Indication for surgery was unstable fractures.
Results: Callous formation on x ray was visible at 4 weeks in eight patients and all fractures had radiological union by 8 weeks. Pin tract infection observed in 2 patients. All patients had pain free hand movements at final follow up with a full range of movements and good hand grip.
Conclusion: K wire fixation gives promising results in unstable metacarpal shaft fractures. It has got advantage of fixing the bone without opening the fracture site which is not possible with mini plate.

Fig: Preoperative radiograph showing displaced 4th metacarpal shaft fracture.

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