%0 Journal Article
%T A Comparison of Locking Plates and Intramedullary Pinning for Fixation of Metacarpal Shaft Fractures
%A Dan Hutt
%A Daniel Dreyfuss
%A Nufar Izacson
%A Raviv Allon
%J HAND
%@ 1558-9455
%D 2019
%R 10.1177/1558944718798854
%X Background: Metacarpal shaft fractures that necessitate surgery are frequently fixated with either intramedullary pins or plates and screws. This study compared outcome measurements of these two techniques. Methods: Patients operated on for closed shaft fractures of metacarpals 2-5 were examined at least 1 year after injury. All fractures were fixated by pinning between years 2013 and 2015 and by locking plates and screws between 2016 and 2017. Evaluation included range of motion measurements for all fingers compared with the contralateral hand; comparison of grip strength; finger alignment and rotation; Disabilities of the Arm, Shoulder and Hand (DASH) score; and radiographic measurements of fracture reduction and healing. Results: Thirty patients with 39 fractured metacarpals treated by pinning were compared with 29 patients with 35 fractured metacarpals treated by locking plate and screws. Both groups had similar characteristics and preoperative fracture patterns on radiograph. Patients in the plate group were found to have significantly improved outcomes in total range of motion of the operated digits (loss of 4กใ extension, 10กใ flexion, and 14กใ total vs 10กใ extension, 19กใ flexion, and 29กใ total), grip strength (93% vs 83% of contralateral hand), rotational deformity (5 digits, 1กใ vs 15 digits, 6กใ), and DASH score (10.5 vs 15.6). Radiographic bone healing time (59 vs 50 days) and operative time (58 vs 41 minutes) were both significantly longer in fractures fixated by plates. Conclusions: Fixation with locking plates allows earlier mobilization without need for splinting. Our study supports the use of this method over intramedullary pinning for metacarpal shaft fractures
%K metacarpal shaft
%K metacarpal fracture
%K locked plate
%K Kirschner wire
%K intramedullary pinning
%U https://journals.sagepub.com/doi/full/10.1177/1558944718798854