Miniplate Versus k Wires in Management of Metacarpal Fracture

Assiut University

Status: Unknown

Conditions: Metacarpal Fracture

Treatments: Device: miniplate

Study type: Interventional

Funder types: Other

Identifiers

NCT04605341

miniplate,k wires and union

Details and patient eligibility

About

To compare between buried k wires and miniplate in management of metacarpal fracture.

Full description

Fractures of the carpals, metacarpals and phalanges account for approximately 15-19% of fractures in adults, with 59% of these occurring in the phalanges, 33% in the metacarpals and 8% in the carpal bones [1]. The single most common fracture site in the hand is the sub capital region of the fifth metacarpal bone (boxer's fracture) [2], which usually results from a direct blow to the metacarpal head [3]. Most hand fractures are caused by accidental falls or other sports-related injuries [4]. Hand fractures are among the most common fractures of upper extremity [5, 6]. Hand fractures can be treated conservatively or surgically, depending on the severity, location and type of fracture. The main objective of both operative and non-operative treatments is to provide fracture stability for early mobilization [7]. Surgical fixation is mainly indicated for displaced fractures because casts are often not sufficient to maintain reduction [8]. Open reduction with internal fixation (ORIF), using pins or plates, has historically been used to stabilize hand fractures which have rotational deformity or lateral angulation [9]. Open reduction may result in scarring, joint stiffness and tendon adhesion [7]. Closed reduction with internal fixation (CRIF), using percutaneous K wire or screws, is now used to treat the majority of unstable closed simple hand fractures [10]. It is generally considered percutaneous Kirschner wire (K wire) fixation may not provide adequate stabilization to allow for early mobilization [8] .

Enrollment: 50 estimated patients

Sex: All

Ages: 20 to 60 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Age: ( 20-60) years,
2. Fresh (fixed within 3 days),
3. Single or multiple fractures of metacarpals.

Exclusion criteria

1. Pathological fracture,
2. Major systemic illness, malignancy,
3. Patient on drugs affecting fracture healing like steroid, anticancer drugs,
4. Polytrauma patients,
5. Extensive comminution of the metacarpal or phalanx detected pre- or intra-operatively,
6. Dislocations at either end of the fractured bone
7. Parents/guardians/patients not willing to participate in study.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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50 participants in 2 patient groups

group one

Active Comparator group

Description:

patient with metacarpal fracture that will use minipate for fixation

Treatment:

Device: miniplate

gruop two

Active Comparator group

Description:

patient with metacarpal fracture that will use buried k wires for fixation

Treatment:

Device: miniplate