Criss-Cross Wires versus Blocking Wires in Management of Metaphyseal Fractures of the Hand (Comparative Study) | ||
| Al-Azhar International Medical Journal | ||
| Volume 2025, Issue 5, May 2025, Pages 88-95 PDF (491.75 K) | ||
| Document Type: Original Article | ||
| DOI: https://doi.org/10.21608/aimj.2025.446559 | ||
| Authors | ||
| Abdel-hakim Abdalla Massoud; Amro Ahmed Fouaad; Mohammed Zahran Shahien* | ||
| Department of Orthopedic Surgery, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt | ||
| Abstract | ||
| Background: Fractures of the hand are prevalent and constitute 10% of all fractures. While some authors suggest that extra-articular fractures with less than thirty percent angular displacement can be treated by splinting and closed reduction, most advocate for surgical fixation due to the risk of displacement. Various techniques, including locked plates, percutaneous K-wire fixation, and open screw fixation, have been described. The latter, introduced 50 years ago, remains popular for minimizing adhesions of the extensor apparatus. Kirschner wires have long been utilized for hand fracture fixation and are still considered one of the best methods. Aim of the Work: This investigation aims to compare the effect of two distinction techniques for fixing extra-articular hand fractures: crisscross wires with splinting and blocking wires without splinting. Patients and Methods: The study involved a comparative analysis of two groups. The first group received crisscross wire fixation with splinting, while the second group received blocking wire fixation without splinting, where the K-wires were connected outside and kept under tension to provide more stability and allow early range of movement. Results: There were no insignificant distinctions among the groups regarding gender, age, risk factors (smoking, DM, HTN), side, mechanism of trauma (RTA, FFH, twisting, direct), displacement, and time before surgery. Both groups demonstrated insignificant distinctions in anesthesia type, operative time, and time to union. However, the blocking group demonstrated a statistically significant decrease in DASH scores and a significant increase in TAM scores at 12 weeks compared to the crossing group. There was an insignificant distinction in TAM scores for the 1st MCB in 12 weeks, but a significant elevation in TAM scores without the 1st MCB was observed in the blocking group. The VAS score at 3 months postoperatively showed a slight increase in the crossing group. Additionally, grip strength measured using a sphygmomanometer at 3 months was significantly different between the groups. Conclusion: While both techniques showed significant differences in most aspects, the blocking technique demonstrated a statistically significant advantage in terms of functional recovery, as evidenced by improved DASH and TAM scores at 12 weeks. | ||
| Keywords | ||
| Hand fractures, extra-articular fractures; Kirschner wires; crisscross wires; blocking wires; DASH score | ||
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