title: Intramedullary Fixation of Metacarpal Fractures Using Headless Compression Screws.
abstract: IntroductionThe purpose of this study is to examine the clinical results of retrograde intramedullary headless screw (IMHS) fixation for metacarpal fractures.MethodsA retrospective review was performed on 16 patients with 18 metacarpal fractures who underwent IMHS fixation at a single institution. The average age was 32 years. The indications for surgery included rotational malalignment (five patients), multiple metacarpal fractures (five patients), angular deformity (four patients), and shortening greater than 5 mm (two patients). The average length of follow-up was 19.4 weeks (median 10.2 weeks).ResultsFunctional outcome was considered excellent in all patients with total active motion in excess of 240 degrees. Active motion was initiated within 1 week of surgery. No secondary surgeries were performed related to a complication of IMHS fixation.ConclusionIMHS fixation of metacarpal fractures is an efficacious treatment modality for patients with comminution, multiple fractures, malrotation, and those who require rapid mobilization. It obviates the need for immobilization or more extensive plate and screw fixation techniques with excellent clinical results.
authors.affiliation: Department of Orthopaedic Surgery, Orthopaedic Hand Surgery Service, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States; Harvard Combined Orthopaedic Residency Program, Massachusetts General Hospital, Boston, Massachusetts, United States.
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Tobert
authors.affiliation: Department of Plastic Surgery, University of Southern California, Los Angeles, California, United States.
authors.forename: Melissa
authors.initials: M
authors.lastname: Klausmeyer
authors.affiliation: Department of Orthopaedic Surgery, Orthopaedic Hand Surgery Service, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States.
authors.forename: Chaitanya S
authors.initials: CS
authors.lastname: Mudgal
keywords: headless compression screw; intramedullary fixation; metacarpal fracture; minimally invasive