Evaluating Kirschner wire fixation versus titanium plating and screws for unstable phalangeal fractures: A systematic review and meta-analysis of postoperative outcomes.

Autor: Mortada H; Division of Plastic Surgery, Department of Surgery, King Saud University Medical City and Department of Plastic Surgery & Burn Unit, King Saud Medical City, Riyadh, Saudi Arabia., AlNojaidi TF; Department of Plastic and Reconstructive Surgery, King Fahad Medical City, Riyadh, Saudi Arabia., Bhatt G; Department of Burns and Plastic Surgery, All India Institute of Medical Sciences, Rishikesh, India., Bafail A; College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia., Koorapaty P; Imperial College School of Medicine, Imperial College London, London, United Kingdom., Alsanad LA; Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia., Almehaid F; Department of Plastic and Reconstructive Surgery, King Fahad Medical City, Riyadh, Saudi Arabia., Alrobaiea S; Department of Plastic Surgery and Burn Unit, Security Forces Hospital, Riyadh, Saudi Arabia., Alalola R; Department of Plastic Surgery, Security Forces hospital, Riyadh, Saudi Arabia., Kattan AE; Division of Plastic Surgery, Department of Surgery, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia.
Jazyk: angličtina
Zdroj: Journal of hand and microsurgery [J Hand Microsurg] 2024 Mar 18; Vol. 16 (3), pp. 100055. Date of Electronic Publication: 2024 Mar 18 (Print Publication: 2024).
DOI: 10.1016/j.jham.2024.100055
Abstrakt: Background: Unstable phalangeal fractures represent a clinical challenge in hand surgery. The choice of fixation method, whether Kirschner wire (K-wire) fixation or titanium plating with screws, often depends on surgeon preference due to the lack of comprehensive comparative data. This article aimed to compare the postoperative outcomes of K-wire fixation versus titanium plating and screws in the treatment of unstable phalangeal fractures.
Methods: This review was conducted according to the PRISMA guidelines for reporting systematic reviews and meta-analyses. A systematic review and meta-analysis of the existing literature was done encompassing PUBMED, EMBASE, Google Scholar, and Cochrane library using the keywords: "K wire/ Kirschner wire", "titanium plate/ screws", "Miniplate/ screws", and "Unstable phalan∗ fracture/ hand fracture".
Results: After screening 2374 articles, 6 final studies with a total of 414 patients were included. Operative time was significantly shorter with K-wire fixation compared to plating, by a mean difference of -27.03 ​min [95% CI -43.80, -10.26] (p ​= ​0.02). Time to radiographic union averaged 7.43 weeks with K-wires versus 8.21 weeks with titanium plates. No statistically significant differences emerged between groups for overall complications (p ​= ​0.69), infection (p ​= ​0.47), malunion (p ​= ​0.36), stiffness (p ​= ​0.11), or need for reoperation (p ​= ​0.10).
Conclusion: K-wire fixation demonstrated shorter mean operating time and faster radiographic union versus plating for unstable phalangeal fractures. These findings can guide surgical decisions and emphasize the need for individualized treatment based on fracture type and patient factors.
Competing Interests: The authors do not have any conflict of interest.
(© 2024 Society for Indian Hand Surgery and Micro Surgeons. Published by Elsevier B.V. All rights are reserved, including those for text and data mining, AI training, and similar technologies.)
Databáze: MEDLINE
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