Research Article Volume 13 issue 2 - November 2018 DOI: 10.19080/OROAJ.2018.13.555859 Ortho & Rheum Open Access J Copyright © All rights are reserved by Elalfy M Mohamed Unstable Metacarpal Fractures: A comparative study between Mini-plates and percutaneus K-wire fixation at Emergency Hospital, Mansoura University, Egypt Nour A Khaled 1* and Elalfy M Mohamed 2 1 Orthopaedic surgery lecturer at Mansoura University Hospital, Faculty of medicine, Egypt 2 Orthopaedic surgery domenstrator at Mansoura University Hospital, Faculty of medicine, Egypt Submission: October 11, 2018; Published: November 29, 2018 *Corresponding author: Nour A Khaled, Orthopaedic surgery domenstrator at Mansoura University Hospital, Faculty of medicine, Egypt Ortho & Rheum Open Access J 13(2): OROAJ.MS.ID.555859 (2018) 001 Orthopedics and Rheumatology Open Access Journal ISSN: 2471-6804 Introduction Metacarpal fractures comprise between 18–44 % of all hand fractures [1-3]. Most metacarpal fractures occur in the active and working population, particularly adolescents and young adults. Trauma to the hand is exceedingly common, frequently resulting in metacarpal, fractures and dislocations [3,4]. Appropriate treatment includes a thorough assessment, physical examination, and directed imaging. Such an approach should lead to a rational treatment plan that focuses on the rehabilitation of all damaged components, including osseous, articular, and soft tissue structures [5,6]. Management of metacarpal shaft fracture is dictated by the stability and personality of the fracture. Undisplaced fracture with any fracture configuration can be managed by conservative method with a slab or a splint immobilising the wrist in Extension and MP joint in flexion greater than 70° (Clam digger slab/cast), allowing early IP mobilisation. [7-11]. No absolute contraindications exist for treatment of metacarpal injuries. Almost all injuries are amenable to either immobilization, closed or open reduction, with or without fixation [12-14]. Disability from hand injury may result in loss of sensation, loss of strength and loss of flexibility, which are the chief functions of the hand. Prevention of disability from hand injuries is the primary goal of treatment. Maintenance of function rather than cosmesis is of paramount concern in the management of hand injuries. The most commonly reported complication is stiffness [15,16]. Extensor lag, infection, tendon rupture, malunion and non-union also are common [17] Infection rates in metacarpal fractures are low. Poor outcomes are directly correlated to the higher degrees of soft tissue injury and contamination [18-20]. Aim of the Work Assessment of management of unstable oblique and spiral metacarpal fractures by open reduction and internal fixation using mini-plates compared to percutaneous Kirschner wire fixation. Patients The study included 40 patients presented at Emergency Hospital, Faculty of Medicine, Mansoura University, with 48 fractured metacarpals in 30 hands. 20 patients were fixed by open reduction and internal fixation using mini-plates (group A), the other 20 patients were fixed by percutanous K wires (group B). Inclusion Criteria i. Unstable spiral and oblique shaft fractures of all metacarpals ii. Age >18 years old iii. Recent metacarpal fractures iv. Closed fractures Abstract Introduction: Management of metacarpal shaft fracture is dictated by the stability and personality of the fracture. It may be conservative or surgical. Surgical management of Metacarpal fractures has different techniques and different instruments. Methods: The study included 40 patients presented at Emergency Hospital, Faculty of Medicine, Mansoura University, with 48 fractured metacarpals in 30 hands. 20 patients were fixed by open reduction and internal fixation using mini-plates, the other 20 patients were fixed by percutanous K wires. Results: In this study, it was found that after 6 weeks of follow up, group A showed 93.3 % satisfactory results, while group B showed 86.7 % satisfactory results, while after 3 months of follow up both groups showed satisfactory and good results in 93.3 % of cases. Conclusion: Mini-plates fixation in oblique and spiral fractures provide stable and rigid internal fixation that allows early active range of motion and early excellent results. Percutaneous K-wire fixation has the advantages of preserving the soft tissue.