Interosseous Wiring Versus Miniplates for Fixation of Displaced Transverse and Short Oblique Metacarpal Shaft Fractures: A Randomized Controlled Trial

Background: Different techniques with variable advantages and shortcomings have been described for the operative treatment of metacarpal fractures, but there is no consensus about the optimal method.Aim: To compare the outcomes of treatment of displaced short oblique and transverse metacarpal fractures by interosseous wires versus miniplates.Patients and Methods: This prospective, randomized clinical trial included 48 patients who were allocated randomly into two equal groups: group A (interosseous wiring) and group B (miniplate osteosynthesis). Patients were evaluated radiologically for union and clinically using total active flexion, total active motion, grip strength, and the QuickDASH score.Results: After a 6-month follow-up period for all patients, the outcomes in both groups were comparable without statistically significant differences. Union was achieved after a mean of 8.8 weeks in group A and 8.3 weeks in group B. In group A, total active flexion was recorded as excellent in 17(70.8%) cases and good in seven (29.2%) cases, while in group B, it was excellent in 21(87.5%) cases and good in three (12.5%) cases. The mean total active motion was 91.7% (range, 75–100%) in group A and 92.1% (range, 87–100%) in group B. The mean grip strength was 92.6% of the contralateral side in group A and 94% in group B. The mean operative time was 46.4min in group A and 47.6min in group B. The mean QuickDASH score at 6 months was 8.7 in group A and 8.6 in group B.Conclusions: Both interosseous wiring and miniplates are effective methods for the treatment of displaced short oblique and transverse metacarpal shaft fractures.