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Review paper
Published: 09.10.2020. Biochemistry
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https://doi.org/10.17392/1310-21

Comparing hand strength and quality life of locking plate versus intramedullary k wire for transverse midshaft metacarpal fractures

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Andrea Pasquino Orcid logo ,
Andrea Pasquino
Contact Andrea Pasquino

Department of Orthopaedics and Traumatology, Vito Fazzi Hospital, Lecce, Italy

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Alessandro Tomarchio ,
Alessandro Tomarchio

Department of Orthopaedics and Traumatology, S. Croce e Carle Cuneo Hospital, Cuneo, Italy

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Enio De Cruto ,
Enio De Cruto

Department of Orthopaedics and Traumatology, Vito Fazzi Hospital, Lecce, Italy

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Jacopo Conteduca ,
Jacopo Conteduca

Department of Orthopaedics and Traumatology, Vito Fazzi Hospital, Lecce, Italy

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Damiano Longo ,
Damiano Longo

Department of Orthopaedics and Traumatology, Vito Fazzi Hospital, Lecce, Italy

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Valentina Russi ,
Valentina Russi

Department of Orthopaedics and Traumatology, Vito Fazzi Hospital, Lecce, Italy

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Giuseppe Pica ,
Giuseppe Pica

Department of Orthopaedics and Traumatology, AORN San Pio, Benevento, Italy

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Luigi Meccariello ,
Luigi Meccariello

Department of Orthopaedics and Traumatology, AORN San Pio, Benevento, Italy

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Giuseppe Rollo
Giuseppe Rollo

Department of Orthopaedics and Traumatology, Vito Fazzi Hospital, Lecce, Italy

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Abstract

Aim
In the scientific literature there are no papers that clarify which method of surgical fixation in transverse metacarpal fractures has the best functional outcomes. The aim of this study was to compare the hand strength obtained using two different methods in the treatment of these fractures.
Methods
A total of 52 patients who presented a transverse metacarpal fracture were enrolled. They were divided in two groups: 26 patients treated with K-wire (IMN) and 26 patients treated with plate and screws (PW). The evaluation criteria were: fracture healing time, performed force testing collected ultimate tensile strength and grip, the Disability Arm Shoulder and Hand (DASH) score, and the range of motion of the hand.
Results
In both groups obtained results were comparable in terms of full hand function, healing and total range of motion and DASH. Results in group K were slightly better than group PW in terms of strength and grip pain within 3 months from osteosynthesis.
Conclusion
Neither of the two techniques, either in the literature or in biomechanical studies, shows to have superior functional
outcomes for fixation of transverse metacarpal fractures. Since the K-wire is cheaper and has no intrinsic complications as compared with plating (such as scar and tendon irritation), fixation with the latter is preferable to the plate in the treatment of these fractures in non-expert hands.

Keywords:

finger,
grip,
hand,
joint,
pain,
stiffness

References

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