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Table 1 Key details of the studies included in the meta-analysis

From: Pin vs plate fixation for metacarpal fractures: a meta-analysis

Author, year of publication

Country

Study design

Subjects

Intervention and control groups; point of assessment

Key outcome

Cha et al. (2019) [15]

Korea

Quasi-experimental

Patients with metacarpal fracture

Mean (SD) age (years) Group 1, 37 (12)

Group 2, 40 (11)

Proportion of male subjects (56/69)—82%

Group 1 (mini-open antegrade intramedullary nailing)

Group 2 (open reduction with internal fixation; ORIF)

Point of assessment: clinical and functional outcomes were assessed at least 2 years after surgery

Final shortening; mean (SD) in mm

Group 1 (N = 36), 0.3 (0.7)

Group 2 (N = 33), 0.1 (0.5)

Final visual analogue score (VAS); mean (SD)

Group 1 (N = 36), 0.3 (0.6)

Group 2 (N = 33), 0.3 (0.6)

Final DASH (disabilities of the arm, shoulder, and hand) score; mean (SD)

Group 1 (N = 36), 4 (3)

Group 2 (N = 33), 6 (3)

Final range of movement (ROM) of the metacarpophalangeal joint (o); mean (SD)

Group 1 (N = 36), 84 (4)

Group 2 (N = 33), 85 (3)

Final grip strength (% of the unaffected side); mean (SD)

Group 1 (N = 36), 94 (5)

Group 2 (N = 33), 91 (5)

Dreyfuss et al. (2018) [16]

Israel

Non-randomized study

Adult patients operated for metacarpal shaft fractures

Mean (range) age of participants (in years)

Group 1, 27.5 (18–55)

Group 2, 29.4 (18–57)

All male subjects

Group 1 (pinning using Kirschner wire)

Group 2 (open reduction with internal fixation with locking plates and screws)

Point of assessment: clinical and functional outcomes were assessed at least 1 year after surgery

Final shortening; mean (SD) in mm

Group 1 (N = 39), 1 (0.8)

Group 2 (N = 29), 0 (0.0)

Final DASH score; mean (SD)

Group 1 (N = 39), 15.6 (8.8)

Group 2 (N = 29), 10.5 (6.7)

Final range of movement (ROM) of the metacarpophalangeal joint (o); mean (SD)

Group 1 (N = 39), 71 (24.2)

Group 2 (N = 29), 86 (12.5)

Final grip strength (% of the unaffected side); mean (SD)

Group 1 (N = 39), 83 (11.6)

Group 2 (N = 29), 93 (13.8)

Vasilakis et al. (2019) [17]

USA

Retrospective chart review

Patients aged over 16 years with single digit, closed isolated extraarticular metacarpal fracture

Mean (SD) age (years) Group 1, 37.9 (17.8)

Group 2, 36.8 (16.1)

Proportion of male subjects (49/70)—70%

Group 1 (closed reduction with percutaneous pinning)

Group 2 (open reduction with internal fixation)

Point of assessment: clinical and functional outcomes were assessed between 3 and 6 months post-operatively

Final DASH score; mean (SD)

Group 1 (N = 44), 16.3 (7.1)

Group 2 (N = 26), 18.7 (6.6)

Final range of movement (ROM) of the metacarpophalangeal joint (o); mean (SD)

Group 1 (N = 44), 90.8 (14.8)

Group 2 (N = 26), 86.7 (20.6)

Pandey et al. (2018) [18]

India

RCT

Patients aged 16–60 years with closed shaft fracture of metacarpal

Mean age (years) of the participants, 29.34

Proportion of male subjects (28/32)—87%

Group 1 (closed reduction with percutaneous pinning using Kirschner wire)

Group 2 (open reduction with internal fixation)

Point of assessment: clinical and functional outcomes were assessed at 2 years post-operatively

Final DASH score; mean (SD)

Group 1 (N = 16), 32.98 (18.2)

Group 2 (N = 16), 36.76 (16.6)

Final range of movement (ROM) of the metacarpophalangeal joint (o); mean (SD)

Group 1 (N = 16), 95.34 (24.9)

Group 2 (N = 16), 95.82 (23.7)

Fujitani et al. (2012) [19]

Japan

Prospective quasi-randomized

Patients with displaced metacarpal neck fracture

Mean (SD) age (years) of the participants, 31 (11)

Group 1, 28 (13)

Group 2, 33 (8)

Proportion of male subjects (26/30)—87%

Group 1 (closed reduction with percutaneous pinning using Kirschner wire)

Group 2 (open reduction with internal fixation)

Point of assessment: clinical and functional outcomes were assessed within 1 year post-operatively

Final shortening; mean (SD) in mm

Group 1 (N = 15), 1.5 (0.4)

Group 2 (N = 15), 0.7 (0.5)

Final range of movement (ROM) of the metacarpophalangeal joint (o); mean (SD)

Group 1 (N = 15), 93 (23)

Group 2 (N = 15), 78 (23)

Final grip strength (% of the unaffected side); mean (SD)

Group 1 (N = 15), 67 (18.3)

Group 2 (N = 15), 86 (20.9)

Ozer et al. (2008) [20]

USA

Prospective quasi-randomized

Patients with closed, displaced extraarticular metacarpal fracture

Mean age (range) (in years) of the participants

Group 1, 25 (19–45)

Group 2, 28 (19–47)

Proportion of male subjects (35/52)- 67%

Group 1 (intramedullary nail fixation)

Group 2 (plate screw fixation)

Point of assessment: clinical and functional outcomes were assessed at 18–19 weeks (i.e., ~ 5 months) post-operatively

Final shortening; mean (SD) in mm

Group 1 (N = 38), 3 (0.83)

Group 2 (N = 14), 0 (0.0)

Final DASH score; mean (SD)

Group 1 (N = 38), 9.47 (4.2)

Group 2 (N = 14), 8.07 (4.5)

Final range of movement (ROM) of the metacarpophalangeal joint (o); mean (SD)

Group 1 (N = 38), 91 (14)

Group 2 (N = 14), 83 (23)

Facca et al. (2010) [21]

France

Prospective comparative non-randomized

Patients with closed, isolated, displaced 5th metacarpal neck fractures

Mean age (in years) of the participants, 32.1

Proportion of male subjects (34/38)—90%

Group 1 (intramedullary K-wire fixation)

Group 2 (locked plate screw fixation)

Point of assessment: clinical and functional outcomes were assessed at a mean follow-up period of 3.3 months in group 1 and 4.8 months in group 2, post-operatively

Final visual analogue score (VAS); mean (SD)

Group 1 (N = 20), 0.9 (1.02)

Group 2 (N = 18), 0.94 (1.14)

Final DASH score; mean (SD)

Group 1 (N = 20), 9.8 (7.99)

Group 2 (N = 18), 15.88 (7.47)

Final range of movement (ROM) of the metacarpophalangeal joint (o); mean (SD)

Group 1 (N = 20), 98 (4)

Group 2 (N = 18), 74 (20)

Final grip strength (% of the unaffected side); mean (SD)

Group 1 (N = 20), 92.9 (20.6)

Group 2 (N = 18), 88.4 (19.0)

Gupta et al. (2007) [22]

India

Prospective comparative non-randomized

Patients aged ≥ 14 years with closed, stable, extraarticular, non-avulsive metacarpal fracture

Mean age (in years) of the participants, 35.6

The study was conducted among male subjects

Group 1 (reduction with percutaneous K-wire fixation)

Group 2 (open/closed reduction with external fixation using locked plate/screw)

Point of assessment: clinical and functional outcomes were assessed at 3 months, post-operatively

Total active range of motion was excellent in 42% (13/31) and good in 48.4% (15/31) of the patients in group 1. In group 2, in 42.8% patients, it was excellent and in 28.6% patients it was good. The observed differences were statistically non-significant.

Total active range of motion was defined in terms of percent regained motion compared to the normal range of digital motion (i.e., 260°); excellent 85 to 100%; good 70–84%; fair 50–69%; and poor < 50%

Takigami et al. (2010) [23]

Japan

Retrospective

Patients operated for metacarpal fractures

Mean (SD) age (in years) of the participants

Group 1, 36 (21)

Group 2, 45 (20)

Proportion of male subjects (53/71)—75%

Group 1 (reduction with percutaneous K-wire fixation)

Group 2 (reduction with low profile plate and screw)

Point of assessment: clinical and functional outcomes were assessed at 6–13 months of being operated

Total active flexion (TAF) was 235° ± 38° in the low profile plate and screw group and 243° ± 22° in the K-wire group. This difference was not statistically significant.

Total extension lag (TEL) was 12° ± 20° in the LPP group and 9° ± 12° in the K-wire group (not significant).