Radiological Outcomes of Mini-Plate versus K-Wire Fixation in Metacarpal Shaft Fractures

Open Access

Abstract

Background: Metacarpal shaft fractures are common hand injuries, and optimal fixation remains controversial. Mini-plate and Kirschner wire (K-wire) fixation are widely employed, yet comparative radiological outcomes are sparsely reported. Aim of the study: To prospectively compare radiological healing, alignment, and complication rates between mini-plate and K-wire fixation in patients with metacarpal shaft fractures. Methods: This prospective comparative study was conducted at the Department of Orthopaedic Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, from January 2023 to March 2025. A total of 28 adult patients (age 18–50 years) with closed metacarpal shaft fractures were enrolled and assigned to either mini-plate (n = 14) or K-wire fixation (n = 14). Standardized surgical techniques and postoperative protocols were applied. Radiological assessments included time to union, angular and rotational alignment, malunion, and implant-related complications. Data were analyzed using appropriate statistical tests, with p < 0.05 considered significant. Result: The mini-plate group demonstrated a significantly shorter mean time to union (7.86 ± 1.03 weeks) compared to the K-wire group (8.14 ± 1.66 weeks, p = 0.044). Early union (≤8 weeks) was achieved in 100% of mini-plate cases versus 78.6% in K-wire cases (p = 0.048). Angular deformity was lower in the mini-plate group (1.9° ± 1.2° vs. 3.8° ± 2.1°, p = 0.032). Malunion, loss of reduction, and non-union occurred exclusively in the K-wire group, although the overall complication rate difference (14.3% vs. 42.9%) did not reach statistical significance (p = 0.094). Conclusion: Mini-plate fixation offers superior radiological outcomes, including faster union and better angular alignment, with fewer complications compared to K-wire fixation in metacarpal shaft fractures. These findings support the use of rigid internal fixation with mini-plates for enhanced mechanical stability and predictable radiological healing.