Comparative Study of Kirschner Wire and Mini-Plate Fixation in Hand Fractures: Functional Outcomes and Postoperative Analgesic Requirements.

BACKGROUND: Metacarpal and phalangeal fractures are common upper limb injuries that significantly affect hand function. Surgical fixation using Kirschner wires (K-wires) and mini-plates is widely practiced, but their comparative effectiveness in terms of functional recovery and postoperative analgesic requirements remains debated. AIM: To compare functional outcomes and postoperative analgesic requirements in patients undergoing K-wire versus mini-plate fixation for metacarpal and phalangeal fractures. METHODOLOGY: A prospective comparative study was conducted on 50 adult patients with unstable metacarpal or phalangeal fractures. Patients were divided into two groups: Group A (K-wire fixation, n = 25) and Group B (mini-plate fixation, n = 25). Outcomes assessed included total active motion (TAM), visual analog scale for pain, time to union, and analgesic requirements. Follow-up was conducted at 1, 3, 6, and 12 months. RESULTS: Both groups showed progressive improvement. K-wire fixation demonstrated significantly better TAM at 12 months (54.70 ± 10.94 vs 28.09 ± 5.62; P < 0.001). Mini-plate fixation showed faster fracture union. Analgesic requirements were higher in the mini-plate group during the early postoperative period. Complication rates were comparable. CONCLUSION: K-wire fixation offers superior long-term functional outcomes and reduced analgesic requirements, whereas mini-plate fixation provides earlier fracture stability and faster union. Implant selection should be individualized.