Background: Hand fractures are one of the most common
fractures presenting at accident and emergency units. Because
of the complexity of the hand; management of hand fractures
can be very challenging. Fixation of hand fractures can be
done by multiple methods including percutaneous K-wires
fixation and open reduction and internal fixation with either
interosseous wiring or mini plate and screws. This comparative
clinical study is to review the indications and long term results
of each method.
Methods: Thirty patients with hand fractures were included
in our study, ten of them treated with percutaneous K wire
fixation (group A), another ten patients were treated with
open reduction and internal fixation with interosseous wiring
(group B)and the last ten patients were treated with open
reduction and internal fixation with miniplate and screws
(group C). The duration of this study was for eleven months
with patient's age ranging from 15-50 years old. The type of
surgical intervention used was determined according to the
fracture pattern.
Results: All patients treated in this study had clinical and
radiological union by the 10th week. Patients treated with
percutaneous K wire fixation had better range of movement
and earlier return to work with less complications than patients
treated with open reduction and internal fixation with interosseous
wiring or mini-plate and screws.
Conclusion: Percutaneous fixation of unstable metacarpal
and phalangeal fractures is a reliable and safe method for the
majority of fracture patterns with higher ROM and less
complications in comparison with the other two methods.