K-wire Versus Plate–Screw Fixation in Fifth Metacarpal Neck Fractures: Functional Outcomes and Treatment Cost
Öz
Background: Fifth metacarpal neck fractures are common hand injuries, and various surgical techniques have been described for their management. However, the comparative effectiveness and cost implications of these techniques remain controversial.
Methods: This retrospective study included 30 patients treated between 2023 and 2024. Patients were divided into two equal groups: K-wire fixation (n=15) and plate–screw fixation (n=15). Outcomes included QuickDASH (qDASH), grip strength measured with a dynamometer, and metacarpophalangeal (MCP) joint range of motion (ROM) recorded as active and passive. Grip strength was analyzed within-patient as operated hand versus contralateral healthy hand. Direct implant-related cost was obtained from the hospital billing system.
Results: All fractures achieved radiographic union. One wound infection and one loss of reduction requiring revision occurred in the plate–screw group; no complications were observed in the K-wire group. Functional outcomes were comparable between groups: qDASH 4.69±3.03 vs 5.60±3.21 (p=0.479). Operated-hand grip strength was 41.1±7.7 kg vs 38.0±8.7 kg (p=0.253), and contralateral healthy-hand grip strength was 40.0±8.9 kg vs 38.0±8.1 kg (p=0.506). Active and passive MCP flexion and extension were similar between groups (p=0.471, p=0.607, p=0.823, and p=0.495). Implant-related cost was markedly lower with K-wire fixation (52.0±12.6 TL vs 9,941.3±827.9 TL; p<0.001).
Conclusion: K-wire fixation provided functional outcomes comparable to those of plate–screw fixation, with substantially lower implant-related cost and fewer soft-tissue–related adverse events in this cohort. These findings suggest that K-wire fixation remains an effective and economical treatment option for fifth metacarpal neck fractures.
Anahtar Kelimeler
fifth metacarpal, boxer’s fracture, Kirschner wire, plate fixation, QuickDASH, grip strength, cost
Destekleyen Kurum
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Proje Numarası
2026/04-302
Etik Beyan
This study was approved by the local ethics committee (Approval no: 302; Date: 04/04/2026).
Teşekkür
None.
Kaynakça
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