Background: There is an increasing tendency to use Minifragment plates over Kirschner's wire for treating hand fractures. The superior method of internal fixation by minifragment plate has several advantages over the Kirschner's wire. The purpose of this comparative study was to evaluate the differences between these two techniques of internal fixation in fractures of metacarpals in terms of radiological union and functional outcome.

Patients and Methods: The study included a total of 30 patients with a mean age of 35.6 years. The patients were divided into two groups (Group A - treated with minifragment plate and Group B - treated with Kirschner's wire) with 15 cases each at Government Medical College and Hospital, Amritsar. The outcomes of treatment were compared in the two groups using Student's t-test and chi-square test.

Results: The average time for radiological union in Group A (minifragment plate) was 7.2 weeks, while it was 9 weeks in Group B (Kirschner's wire). There was no statistically significant difference in the radiological union time between the two groups (P = 0.274, chi-square = 2.59). Stiffness was the most common associated complication in this study. It was more common in the group treated with Kirschner's wire (26.7%) compared to the group treated with Minifragment plating (13.3%). In Group A, 86.7% of cases had shown good to excellent results; while in Group B, 80% of the cases had similar result. There was no statistically significant difference (P = 0.938, chi-square = 0.410) in outcome in both groups.

Conclusions: Both Kirschner's wire and minifragment plate are good methods of internal fixation in fractures of metacarpal. Though patients who were treated with minifragment plating had better functional results, but the difference was not statistically significant.

Keywords: Kirschner′s wire, minifragment plate, metacarpal fracture.

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Dr Partap Singh Verka

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