Abstract
Objectives: We purposed to determine which of the surgical treatment options for metacarpal and phalangeal fractures, a subject that has limited coverage in the literature, is best.
Methods: Sixty-three patients who were surgically treated for closed and extra-articular metacarpal (41.9%) and phalangeal (58.1%) fractures were included in a randomized prospective clinical trial between August 2015 and August 2017. The patients were divided into three groups using block randomization: open reduction and internal fixation (ORIF) with miniplate plus screw fixation (MP Group; 6F/15M), ORIF with screw only fixation (SO Group; 5F/16M), and closed reduction and percutaneous K-wire fixation (KW Group; 3F/18M). The patients were followed up at 10 days and 3 weeks for wound care, at 3 months, and at the end of the first year and assessed based on dynamometer measurement, Q-DASH, and range of motion (ROM).
Results: Time to return to work was 77.56 ± 33.85 days, while Q-DASH scores at 3 months and 1 year and dynamometer values at 3 months were significantly higher in KW Group (p<0.05). Although ROM was higher in KW Group in patients with metacarpal and phalangeal fractures of metacarpophalangeal joint, ROM of PIP joint and total ROM were significantly lower (p<0.05). Total ROM of thumb fracture cases was not significantly different from that of the other cases (p>0.05).
Conclusion: Miniplates should be used for metacarpal fractures and screw only for phalangeal fractures in those with occupations requiring fine skills while pinning should be used in those with professions involving heavy work.

Key words: cross-pin; hand fracture; metacarpal; miniplate; phalanx; screw.