IM Screw vs. K-wire Fixation of Proximal/Middle Phalanx Fractures
Intramedullary Screw Versus Kirschner Wire Fixation of Extraarticular Proximal and Middle Phalanx Fractures: Pilot Study for a Randomized Controlled Trial
McMaster University
34 participants
Apr 1, 2025
INTERVENTIONAL
Conditions
Summary
When people break their fingers, sometimes surgery is needed to align the bones to heal them properly. There are different ways to fix broken bones in hands, such as plates, pins, or screws. Each method has pros and cons; fixing a broken bone with plates is usually a larger surgery with more cutting but holds the bones very securely. Pins require little to no cutting but the patient needs to immobilize their hand for a few weeks afterwards. Screws are a newer method of fixing broken fingers that requires little cutting and also holds the bones securely. The goal of this study is to compare the effectiveness of using pins versus screws in surgery for broken fingers. The investigators are studying whether using screws leads to better hand function, patient satisfaction, and quicker return to work.
Eligibility
Inclusion Criteria4
- adult patients ≥18 years old
- scheduled for operative management of extraarticular proximal or middle closed phalanx fracture(s) at the investigators' tertiary hospital
- feasible to perform closed reduction
- able to provide informed consent and complete health-related quality of life (HRQoL) questionnaires in English
Exclusion Criteria4
- other fractures that cannot be managed with IM screws or K-wires
- other intraarticular fractures
- significant concomitant hand trauma
- cannot commit to 3 months of follow up at the investigators' institution
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Interventions
Intramedullary (IM) screw fixation is a minimally invasive technique that provides rigid fixation of fractures, acting as an internal splint and load-sharing device. IM screw fixation may allow for early mobilization without the operative site morbidity of open reduction and its associated complications.
Kirschner wire (K-wire) fixation is a minimally invasive technique that provides non-rigid fixation of fractures. K-wires allow for fracture fixation with minimal soft tissue injury and preserved blood supply. However, patients require prolonged postoperative immobilization and are at risk of malunion and pin tract infection.
Locations(1)
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NCT06372067