Abstract: Introduction: A majority of metacarpal and proximal phalynx fracture can be effectively managed with closed reduction and cast and buddy taping. However a group metacarpal and proximal phalynx fractures are unstable and reducible, but difficult to put in reducible position within plaster cast or buddy taping till union of the fractures, for those fractures cross pinning with ‘k’ wires is required. Lots of other technique i.e. external fixation, miniplate, L pinning for fixation of metacarpal and proximal phalynx fracture are also available.
Aim: Aim of this study is Functional outcome of cross pinning of metacarpal and proximal phalanges fracture of the hand.
Material and method: 25 patients with metacarpal and phalynx fracture were treated with cross intramedullary ‘k’ wire fixation between June 2016 – 2018 in Pravara rural hospital-loni (Maharashtra). Out of 25 patients 18 are males and 7 are females, of which 14 were having metacarpal fracture and 11 were having proximal phalynx fracture.
Result: All 25 patients were followed up for more than 3 months. 1 patient (female) developed sudecks osteodystrophy. At final follow up 4 patients had residual pain measuring 2-3 on visual analogue scale. All patients regained full range of motion at metacarpo-phalyngeal and interphalyngeal joints. Fracture union was evaluated at each x-ray and patient satisfaction was evaluated as excellent, good, fair or poor.
Discussion: In our study early mobilisation of the joint to reduce the stiffness k wires used for fixation are cheap, easily available and doesn’t require costly instrumentation. Clinicoradiological confirmation was done at the end of every surgery to confirm acceptable reduction. There was no clinical shortening of metacarpals and phalanges.
Conclusion: Comminutted fractures and intra-articular fractures, k wire not suitable. It is relatively simple, cost effective and definite advantages over other techniques for fracture stabilisation.
