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Outcome of Non-thumb Metacarpal Shaft Fractures Treated by Two Different Techniques - K Wire and Herbert Screw
Dinesh Raj Selvaraj1, Makesh Ram Sriraghavan2, Naveen Venkidusamy1
1Department of Orthopaedics, Government Thoothukudi Medical College, Thoothukudi, Tamil Nadu, India.
Introduction:
Metacarpal fractures are one of the most commonly encountered musculoskeletal injuries in the hand often caused by road traffic accidents, trivial fall or workplace injuries. It can lead to severe disability of the hand if left untreated or improperly treated. About 88% of all metacarpal fractures are non-thumb metacarpals, with the fifth finger being most frequently affected. Hence, achieving optimal function will be the primary goal, though it remains challenging.
Materials And Methods:
A prospective study done at Government Thoothukudi Medical College for a period of 3 years from March 2022 to February 2025. There are about 40 patients of multiple metacarpal fractures fixed with K-wire and Herbert screws. Each group consists of 20 patients. Both groups are followed up at 3rd week, 6th week, 10th week, and 16th week postoperatively. Assessment done by radiological union, grip strength, range of movements, early return to activity, and disability of arm, shoulder, and hand (DASH) score.
Results:
A significantly shorter time to fracture union in the Herbert screw group, compared to K-wire group, was observed. Herbert screw group demonstrated better range of movements, early return to activity and grip strength postoperatively. DASH questionnaire showed excellent results in the Herbert screw group compared to K-wire group.
Conclusion:
Our study concludes that healing time was significantly lower in the Herbert screw group. Range of movements and grip strength was also better in the Herbert screw group. Thus, we conclude that the Herbert screw has a better functional outcome in the management of displaced metacarpal shaft fractures compared to the K-wire group.
