Cemented K-wire Fixation vs Plating for Finger Fractures

Shaft fractures of the proximal phalanx are common injuries that may significantly affect hand function. Good fracture stability to allow early mobilization of joints and thus early return of function. The objective of this report is to introduce a novel external-fixation technique using the combination of K-wires and cement. For comparison, we also included another group of patients who were treated using a mini plate and screw system. A total of 104 patients (131 fingers) were randomly allocated into group A (56 patients) and B (51 patients). Patients in group A were treated with cemented K-wire fixation; and patients in group B were treated with conventional mini-plate. Bone healing, range of motion of the fingers, costs of treatments, and patient satisfaction were assessed.

Inclusion criteria

• patient aged between 18 and 65 years;
• acute fractures within 15 days;
• closed fracture or open injury with small wound less than 1.5 cm;
• involvement of proximal phalanges of index to little fingers; shaft fractures;
• at least 5 mm in length of the most distal and proximal fragments so that the K-wires or screws can be engaged;
• oblique, spiral, and comminuted fractures;
• normal opposite hand for comparison.

Exclusion criteria

• patients younger than 18 years are excluded because of skeletal immaturity;
• patients older than 65 years are excluded because of possible osteoporosis;
• severe open injury or crush injuries; tendon or neurovascular injuries; - involvement of articular surface;
• old fractures exceeding 15 days because close reduction was most likely difficult;
• a combined tendon, nerve, or artery injuries or diseases; diabetes, gout, ganglion;
• osseous tumors, and other disease affecting bony structures and joint motion;
• patients who declined to participate.