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Outcomes and complications of exposed Kirschner wire f ixation for metacarpal fractures: a retrospective study

By
Andrea Cruciani Orcid logo ,
Andrea Cruciani
Contact Andrea Cruciani

Department of Orthopaedics and Traumatology, Università Cattolica del Sacro Cuore UCSC, Agostino Gemelli University Polyclinic , Rome , Italy

Silvia Pietramala ,
Silvia Pietramala

Department of Orthopaedics and Traumatology, Università Cattolica del Sacro Cuore UCSC, Agostino Gemelli University Polyclinic , Rome , Italy

Alessio Greco ,
Alessio Greco

Department of Orthopaedics and Traumatology, Università Cattolica del Sacro Cuore UCSC, Agostino Gemelli University Polyclinic , Rome , Italy

Alessandro El motassime ,
Alessandro El motassime

Department of Orthopaedics and Traumatology, Università Cattolica del Sacro Cuore UCSC, Agostino Gemelli University Polyclinic , Rome , Italy

Camillo Fulchignoni ,
Camillo Fulchignoni

Hand Surgery and Orthopedics Unit, Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario A. Gemelli, Agostino Gemelli University Polyclinic , Rome , Italy

Lorenzo Rocchi
Lorenzo Rocchi

Hand Surgery and Orthopedics Unit, Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario A. Gemelli, Agostino Gemelli University Polyclinic , Rome , Italy

Editor: SELMA UZUNOVIĆ

Abstract

Aim Metacarpal fractures are common hand injuries, frequently treated with closed reduction and internal fixation (CRIF) using Kirschner wires (K-wires). While exposed K-wires allow for simple hardware removal and early mobilization, their use is traditionally associated with a higher risk of pin tract infections. There is a lack of studies focusing exclusively on exposed K-wires in metacarpal fractures.

Methods It was retrospectively reviewed 134 patients who underwent CRIF with exposed K-wires for metacarpal fractures between January 2023 and March 2024. After applying inclusion and exclusion criteria, 118 patients were analyzed. Demographics, fracture characteristics, complications, and follow-up data were collected. Functional outcomes were assessed using the QuickDASH and the Michigan Hand Outcomes Questionnaire (MHQ) before hardware removal.

Results Most patients were male, 88 (75%), with a mean age of 39.3 years. The little finger was the most frequently injured, 71 (60%). In 102 (86%) cases, a single metacarpal fracture was observed. The average number of wires used was 1.7, and hardware was removed after a mean of 40.1 days. The rate of pin tract infection was <4%, all classified as superficial and managed conservatively. Only one case required reoperation due to secondary displacement. The mean QuickDASH score was 25, and the average MHQ score was 70.15, indicating overall good functional and patient-reported outcomes.

Conclusion Exposed K-wire fixation for metacarpal fractures appears safe and reliable, with low complication rates and favorable patient-reported outcomes, supporting its use in outpatient pathways without compromising safety.

Author Contributions

Conceptualization, A.C., S.P., C.F. and L.R.; Data curation, A.C. and S.P.; Formal Analysis, A.C., S.P. and A.G.; Methodology, A.C., S.P. and A.G.; Visualization, A.C. and S.P.; Writing – original draft, A.C., S.P. and A.G.; Writing – review & editing, A.C., S.P., A.G. and A.E.M.; Resources, A.G. and A.E.M.; Investigation, A.E.M.; Project administration, C.F. and L.R.; Supervision, C.F. and L.R.; Validation, C.F. and L.R. All authors have read and agreed to the published version of the manuscript.

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Funding Statement

This research received no external funding

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