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. 2023 Sep 8;31(spe3):e266948.
doi: 10.1590/1413-785220233103e266948. eCollection 2023.

METACARPAL FRACTURES TREATMENT: COMPARASION BETWEEN KIRSCHNER WIRE AND INTRAMEDULLARY SCREW

Bruno Cesar Silva de Jesus  1 , Clóvis Rodrigo Guimarães Braz Pereira da Silva  2 , Rodrigo Domiciano Cardoso  2 , Vitor Augusto Queiroz Mauad  3 , Rafael Saleme Alves  3 , Fernando Nogueira Zambone Pinto  3
Affiliations

METACARPAL FRACTURES TREATMENT: COMPARASION BETWEEN KIRSCHNER WIRE AND INTRAMEDULLARY SCREW

Bruno Cesar Silva de Jesus et al. Acta Ortop Bras. .

Abstract
in English, Portuguese

Introduction: Metacarpal fractures are common and can be treated surgically using Kirschner wires (K-wires) or intramedullary fixation with compression screws (IMCS).

Objectives: Analyze the postsurgical results from treating the metacarpal extra-articular fractures through the retrograde Kirschner wire technique, and compare it with the intramedullary compression screw fixation. Methods: Retrospective and quantitative studies were to analyze patients' medical records, and a postsurgical evaluation questionnaire was given to the patients, who were divided into K-wire and IMCS.

Results: The period of immobilization with a splint took six weeks for the K-wire group and four weeks for the IMCS group. The average time for consolidation took, respectively, fifty-seven days and forty-seven days. The first group could restart their activities twenty-two days after the other, and the average force value of the treated hand, when compared with its contralateral, was 93.9% and 95.4%, respectively. Between the operated hand and its contralateral, there was a difference of 16° in the total measures of the metacarpophalangeal and interphalangeal joint's range of movement among the K-wire group and 5° among the IMCS group.

Conclusion: The patients who participated in this study showed excellent results after surgery, and both treatments were proven to be safe and reliable. Evidence level III; Retrospective comparative study .

Introdução: Fraturas dos metacarpos são frequentes e podem ser tratadas de forma cirúrgica com os fios de Kirschner (FK) e Fixação Intramedular com Parafuso de Compressão (FIPC).

Objetivo: Analisar os resultados pós-operatórios do tratamento das fraturas extra-articulares dos metacarpos pela técnica retrógrada com fios de Kirschner e comparar com a fixação intramedular utilizando parafuso de compressão.

Métodos: Estudo retrospectivo, quantitativo, com análise de prontuários, utilizando questionários de avaliação pós-operatória em dez pacientes divididos em dois grupos: FIPC e FK.

Resultados: O período de imobilização com tala nos grupos FK e FIPC foram de seis e quatro semanas respectivamente, já o tempo médio para consolidação foi de 57 e 47 dias respectivamente. O grupo FK retornou as atividades laborais após os FIPC. O valor médio de força na mão acometida comparada a contralateral foi de 93,9% no grupo FK, e no FIPC de 95,4%. Medidas da soma de amplitude de movimento das articulações metacarpofalangeanas e interfalangeanas no grupo FK obtiveram diferença média entre as mãos operada e a contralateral de 16°, já na FIPC observou-se 5°.

Conclusão: Os pacientes estudados apresentaram excelentes resultados pós-operatórios e ambos os tratamentos provam ser seguros e confiáveis. Nível de evidência III; Estudo retrospectivo comparativo .

Keywords: Bone Fracture; Fracture Fixation, Intramedullary; Kirschner Wires; Metacarpus; Trauma.

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Conflict of interest statement

All authors declare no potential conflict of interest related to this article.

Figures

Figure 1
Figure 1. A) Anteroposterior radiograph in the immediate postoperative period of fixation of the 5° metacarpal diaphyseal fracture with FK. B) Retrograde intramedullary fixation technique with FK. C) Anteroposterior radiograph - Consolidation of the 5° metacarpal diaphyseal fracture.
Figure 2
Figure 2. A) Anteroposterior radiograph – Diaphyseal fracture of the 4° metacarpal. B) IMCS surgical technique. C) Anteroposterior radiograph–Consolidation of the 4° metacarpal diaphyseal fracture.
See this image and copyright information in PMC

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