Comparison between Intramedullary K Wires versus Mini Plate Fixation in Isolated Displaced Shaft Lesser Metatarsal Fractures

Abstract Background Metatarsal (MT) fractures are common foot injuries and account for almost half of all foot fractures. The five metatarsals are the biggest bones in the forefoot and are essential for weight bearing in the last stages of the stance phase. Objective to compare between intramedullary K wires versus mini plate fixation in isolated displaced shaft lesser metatarsal fractures regarding the time and rate of fracture healing, as well as the functional outcome of the surgically treated and American Orthopedic Foot and Ankle Society (AOFAS) functional score for the forefoot and related complications of each fixation method. The objective is to perform a systematic review of comparison between intramedullary K wires versus mini plate fixation in isolated displaced shaft lesser metatarsal fractures. Patients and Methods This study was conducted following the preferred items for systematic review meta-analysis (PRISMA) to answer the question of which is better k-wire intramedullary nailing fixation or Open reduction and internal fixation with plate and screws according to the AOFAS score and time until union and complications. Results Our study represents that fixation techniques by K-wire intramedullary nailing has statistically significant superiority of surgical treatment for lesser metatarsal acute shaft fractures. Optimal reduction and fixation of the fracture with less surgical insult can be achieved by K-wiring, leading to a significantly quicker recovery as a comparison with the plate and screws fixation. Open reduction and internal fixation with plate and screws are accompanied with prolonged healing period, longer timeline of rehabilitation and hardware discomfort. Data Sources Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2021. Conclusion Lesser metatarsal fractures with good prognosis have been well treated by percutaneous closed antegrade intramedullary pinning in di placed fractures because it offers immediate mobilization of the joint and partial weight-bearing in a stiff-soled shoe. In elite injured personnel as athletes and dancers etc., they need special methods of rehabilitation depend on the patient’s career and his or her available period of rehabilitation. Open reduction and internal fixation with plate and screws are accompanied with prolonged healing period, longer timeline of rehabilitation and hardware discomfort.