Authors : Dr. Apoorv Jha; Dr. Pardeep Duhan; Dr. Rajat Saran

Volume/Issue : Volume 11 - 2026, Issue 4 - April

Google Scholar : https://tinyurl.com/yawabk8z

Scribd : https://tinyurl.com/yuh6spxm

DOI : https://doi.org/10.38124/ijisrt/26apr2358

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Abstract : Background: Metacarpal shaft fractures represent a significant proportion of hand injuries and frequently occur in young active individuals. Various surgical techniques are available for unstable fractures, including intramedullary K‑wire fixation and mini‑plate fixation. The optimal method of fixation remains debated.  Aim: To compare intramedullary K‑wire fixation with mini‑plate and screw fixation in unstable metacarpal shaft fractures in adults.  Methods: This prospective comparative study was conducted in the Department of Orthopaedics at RKDF Medical College Hospital & Research Centre, Bhopal, between March 2025 and February 2026. Thirty adult patients with closed shaft fractures of the medial four metacarpals were included. Patients were divided into two groups: Group A treated with intramedullary K‑wire fixation (n=15) and Group B treated with mini‑plate fixation (n=15). Outcome parameters included operative duration, time to radiological union, functional outcome using QuickDASH score and Total Active Flexion (TAF), and complication rates.  Results: Mean fracture union time in the K‑wire group was 6.0 ± 1.4 weeks compared with 10.0 ± 2.1 weeks in the mini‑plate group (p = 0.001). Operative duration was significantly shorter in the K‑wire group (18 ± 3 minutes) compared with the mini‑plate group (40 ± 5 minutes; p < 0.001). Functional outcomes assessed by QuickDASH score and Total Active Flexion were comparable between the two groups.  Conclusion: Both intramedullary K‑wire fixation and mini‑plate fixation provide satisfactory clinical and functional outcomes in unstable metacarpal shaft fractures. Intramedullary fixation offers advantages of shorter operative time and minimal soft‑tissue dissection, whereas mini‑plate fixation provides rigid fixation and improved rotational control.

Keywords : Metacarpal Fractures; Intramedullary K‑Wire; Mini‑Plate Fixation; Hand Fractures; ORIF.

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