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Comparative Study of Kirschner Wire and Mini-Plate Fixation in Hand Fractures: Functional Outcomes and Postoperative
Dhayananth Rathinavel1, K Balaji Subramaniam1, S Pajani1
1Department of Orthopaedics, Vinayaka Mission's Medical College, Karaikal, Vinayaka Mission's Research Foundation (DU), Salem, Tamil Nadu, India.
Background:
Metacarpal and phalangeal fractures are common upper limb injuries that significantly affect hand function. Surgical fixation using Kirschner wires (K-wires) and mini-plates is widely practiced, but their comparative effectiveness in terms of functional recovery and postoperative analgesic requirements remains debated.
Aim:
To compare functional outcomes and postoperative analgesic requirements in patients undergoing K-wire versus mini-plate fixation for metacarpal and phalangeal fractures.
Methodology:
A prospective comparative study was conducted on 50 adult patients with unstable metacarpal or phalangeal fractures. Patients were divided into two groups: Group A (K-wire fixation, n = 25) and Group B (mini-plate fixation, n = 25). Outcomes assessed included total active motion (TAM), visual analog scale for pain, time to union, and analgesic requirements. Follow-up was conducted at 1, 3, 6, and 12 months.
Results:
Both groups showed progressive improvement. K-wire fixation demonstrated significantly better TAM at 12 months (54.70 ± 10.94 vs 28.09 ± 5.62; P < 0.001). Mini-plate fixation showed faster fracture union. Analgesic requirements were higher in the mini-plate group during the early postoperative period. Complication rates were comparable.
Conclusion:
K-wire fixation offers superior long-term functional outcomes and reduced analgesic requirements, whereas mini-plate fixation provides earlier fracture stability and faster union. Implant selection should be individualized.
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