title: Headless Compression Screw Versus Kirschner Wire Fixation for Metacarpal Neck Fractures: A Biomechanical Study.
abstract: OBJECTIVE
  This study aimed to determine the biomechanical stability of headless compression screws in the fixation of metacarpal neck fractures and to compare them with another common, less invasive form of fixation, K-wires. The hypothesis was that headless compression screws would show higher stiffness and peak load to failure than K-wire fixation.
  
  
  METHODS
  Eight matched-paired hands (n = 31), using the ring and little finger metacarpals, had metacarpal fractures simulated at the physeal scar. Each group was stabilized with either a 3.5-mm headless compression screw or 2 0.045-in (1.1-mm) K-wires. Nineteen metacarpals were tested in 3-point bending and 12 in axial loading. Peak load to failure and stiffness were calculated from the load displacement curve. Bone mineral density was recorded for each specimen.
  
  
  RESULTS
  Bone mineral density was similar in the 2 groups tested for 3-point bending and axial loading. Stiffness was not significantly different in 3-point bending for headless compression screws and K-wires (means, 141.3 vs 194.5 N/mm) but it was significant in axial loading (means, 178.0 vs 111.6 N/mm). Peak load to failure was significantly higher in headless compression screws in 3-point bending (means, 401.2 vs 205.3 N) and axial loading (means, 467.5 vs 198.3 N).
  
  
  CONCLUSIONS
  Compared with K-wires, headless compression screws for metacarpal neck fractures are biomechanically superior in load to failure, 3-point bending, and axial loading.
  
  
  CONCLUSIONS
  Headless compression screws demonstrate excellent biomechanical stability in metacarpal neck fractures. In conjunction with promising clinical studies, these data suggest that headless compression screws may be an option for treating metacarpal neck fractures.
authors.affiliation: UCONN Orthopaedic Sports Medicine, University of Connecticut Musculoskeletal Institute, Farmington, CT. Electronic address: Danielavery04@yahoo.com.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Avery
authors.affiliation: UCONN Orthopaedic Sports Medicine, University of Connecticut Musculoskeletal Institute, Farmington, CT.
authors.forename: Stephen
authors.initials: S
authors.lastname: Klinge
authors.affiliation: UCONN Orthopaedic Sports Medicine, University of Connecticut Musculoskeletal Institute, Farmington, CT.
authors.forename: Felix
authors.initials: F
authors.lastname: Dyrna
authors.affiliation: UCONN Orthopaedic Sports Medicine, University of Connecticut Musculoskeletal Institute, Farmington, CT.
authors.forename: Leo
authors.initials: L
authors.lastname: Pauzenberger
authors.affiliation: UCONN Orthopaedic Sports Medicine, University of Connecticut Musculoskeletal Institute, Farmington, CT.
authors.forename: David
authors.initials: D
authors.lastname: Lam
authors.affiliation: UCONN Orthopaedic Sports Medicine, University of Connecticut Musculoskeletal Institute, Farmington, CT.
authors.forename: Mark
authors.initials: M
authors.lastname: Cote
authors.affiliation: UCONN Orthopaedic Sports Medicine, University of Connecticut Musculoskeletal Institute, Farmington, CT.
authors.forename: Jessica
authors.initials: J
authors.lastname: DiVenere
authors.affiliation: UCONN Orthopaedic Sports Medicine, University of Connecticut Musculoskeletal Institute, Farmington, CT.
authors.forename: Elifho
authors.initials: E
authors.lastname: Obopilwe
authors.affiliation: UCONN Orthopaedic Sports Medicine, University of Connecticut Musculoskeletal Institute, Farmington, CT.
authors.forename: Augustus
authors.initials: A
authors.lastname: Mazzocca
authors.affiliation: UCONN Orthopaedic Sports Medicine, University of Connecticut Musculoskeletal Institute, Farmington, CT.
authors.forename: Craig
authors.initials: C
authors.lastname: Rodner
mesh_terms: D000368:Aged; D001863:Bone Screws; D001864:Bone Wires; D002102:Cadaver; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D050279:Metacarpal Bones / Q000293:injuries*; D008875:Middle Aged; D016059:Range of Motion, Articular; D016474:Weight-Bearing
keywords: Metacarpal; fracture; neck; return to play; surgery