Percutaneous Pinning Versus ORIF For Treatment Of Extraarticular Metacarpal Fractures

Abstract

Objectives: Metacarpal fractures are common, and several surgical treatment methods have been described. This study aims to compare the clinical and economic aspects of two different surgical methods, closed reduction and K-wire fixation (CRPF) and open reduction and plate screw fixation (ORIF). Methods: Between January 2009 and March 2014, 51 patients who received surgical treatment for metacarpal fractures were retrospectively evaluated. Of them, 36 patients (29M, 7F) performed CRPF, and 15 (12M, 3F) performed ORIF. Patients were followed up for an average of 17.6 weeks. All patients were assessed according to the union, operation time, complications, cost-effectiveness, and the Michigan hand outcome questionnaire scores. Results: The mean operation time was 13.7 minutes (5-37 minutes) in the CRPF group and 32.2 minutes (23-62 minutes) in the ORIF group (p<0.05). The mean union time was 5.4 weeks (4-9 weeks) in the CRPF group and four weeks (3-8 weeks) in the ORIF group (p<0,05). Hospital expenses were found to be, on average, 257.5 USD (45.8-311 USD) in the CRPF group and 660 USD (454.9-1074.6 USD) in the ORIF group (p<0,05). The mean Michigan Hand Surgery Outcome Questionnaire results were 86.4% (66-98) in the CRPF group and 68.7% (62-83) in the ORIF group (p<0,05). Conclusion: We recommend CRPF because of its shorter operation time, better functional scores, and cost-effectiveness. Type of study/level of evidence: Level III; Causal comparative retrospective study