Is ideal treatment of metacarpal and phalangeal fractures possible? Clinical and radiological outcomes of three surgical choices

Abstract

Objectives: We purposed to determine which of the surgical treatment options for metacarpal and phalangeal fractures, a subject that has limited coverage in the literature, is best. Methods: Sixty-three patients who were surgically treated for closed and extra-articular metacarpal (41.9%) and phalangeal (58.1%) fractures were included in a randomized prospective clinical trial between August 2015 and August 2017. The patients were divided into three groups using block randomization: open reduction and internal fixation (ORIF) with miniplate plus screw fixation (MP Group; 6F/15M), ORIF with screw only fixation (SO Group; 5F/16M), and closed reduction and percutaneous K-wire fixation (KW Group; 3F/18M). The patients were followed up at 10 days and 3 weeks for wound care, at 3 months, and at the end of the first year and assessed based on dynamometer measurement, Q-DASH, and range of motion (ROM). Results: Time to return to work was 77.56 ± 33.85 days, while Q-DASH scores at 3 months and 1 year and dynamometer values at 3 months were significantly higher in KW Group (p