Background: Metacarpal fractures are common hand injuries, and K-wire fixation remains a widely used treatment. However, outcomes during resource-constrained settings such as the COVID-19 pandemic are underreported. This study aimed to evaluate the short-term functional outcomes of metacarpal fractures treated with K-wire fixation in a COVID-19 treatment center and assess the influence of fracture type and treatment timing on recovery.

Methods: A prospective observational study was conducted at Patan Hospital from September 2020 to September 2021. Nineteen patients with 29 ipsilateral metacarpal fractures were treated with open or closed reduction and K-wire fixation, followed by immobilization and physiotherapy. Functional outcomes were assessed at six and 12 weeks using ASSH-TAM and QuickDASH-NP scores. Data were analyzed using descriptive statistics and the Mann-Whitney U test.

Results: At 12 weeks, the mean TAM was 215.72 ± 51.01, TAM % was 81.87 ± 18.45, and QuickDASH-NP score was 23.03 ± 14.74. Mean union time was 6.82 ± 1.6 weeks. Isolated fractures had significantly better TAM and QuickDASH-NP scores than multiple fractures (p < 0.01). Closed fractures showed superior outcomes compared to open fractures (p < 0.05). Delayed treatment did not affect final functional outcomes but was associated with longer union time.

Conclusions: K-wire fixation provides good short-term functional outcomes in metacarpal fractures, even in delayed or resource-limited settings such as during the COVID-19 pandemic. Closed and isolated fractures had more favorable results.

Keywords: COVID-19; K-wire fixation; Metacarpal fractures; TAM score; QuickDASH-NP