title: Treatment of proximal phalangeal fractures with an antegrade intramedullary screw: a cadaver study.
abstract: The aim of this study was to quantify the articular cartilage defect created with two different antegrade techniques of intramedullary osteosynthesis with a headless compression screw inserted through the metacarpophalangeal joint. In 12 out of 24 fingers from six cadaveric hands, a trans-articular technique with cannulated headless compression screws (2.2 and 3.0 mm diameter) was used; whereas in the other 12 fingers, an intra-articular fixation technique was used. The areas of the articular surface and the defects created were measured with a digital image software program. All measurements were made twice by two observers. In the intra-articular technique, the average defect in the base of the articular surface of the proximal phalanx was 4.6% with the 2.2 mm headless compression screw and 8.5% with the 3.0 mm screw. In the trans-articular technique, the defect size was slightly smaller; 4.2% with the 2.2 mm screw and 8% with the 3.0 mm screw, but the differences were not statistically significant. The main advantage of the intra-articular technique was that it avoided damage to the articular surface of the metacarpal head.
authors.affiliation: Plastic and Hand Surgery Department, University Hospital of Zurich, Zurich, Switzerland.
authors.forename: P
authors.initials: P
authors.lastname: Borbas
authors.affiliation: Anatomic Institute, Medical University of Graz, Graz, Austria.
authors.forename: M
authors.initials: M
authors.lastname: Dreu
authors.affiliation: Plastic and Hand Surgery Department, University Hospital of Zurich, Zurich, Switzerland.
authors.forename: A
authors.initials: A
authors.lastname: Poggetti
authors.affiliation: Plastic and Hand Surgery Department, University Hospital of Zurich, Zurich, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Calcagni
authors.affiliation: Plastic and Hand Surgery Department, University Hospital of Zurich, Zurich, Switzerland t_giesen@hotmail.com.
authors.forename: T
authors.initials: T
authors.lastname: Giesen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001863:Bone Screws; D002102:Cadaver; D005260:Female; D050278:Finger Phalanges / Q000293:injuries*; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D050723:Fractures, Bone / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008662:Metacarpophalangeal Joint / Q000473:pathology / Q000601:surgery
keywords: Proximal phalanx; cartilage defect; finger fracture; headless compression screw; intramedullary osteosynthesis