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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).