Percutaneous Osteosynthesis with Headless Cannulated Screws in the Treatment of Metacarpal and Proximal and Middle Phalanxes Fractures of the Hand

Abstract

Introduction There is a high incidence of hand fractures, and a high percentage of them require surgical treatment. The functional result depends, to a large extent, on the technique used. The use of retrograde intramedullary screws allows for early mobilization and minimal dissection of soft tissues. The objective of the present study is to analyze the clinical results and complications with this type of osteosynthesis.

Methods A total of 96 fractures in 81 patients were analyzed. There were 62 metacarpal fractures, 60% of which involved the 5^th finger, 29% involved the 4^th, 5% involved the 3^rd, and 6% involved the 2^nd finger. There were 34 fractures of the phalanxes, 27 of which (79.5%) involved the proximal phalanx, and 20.5% involved the middle phalanx. The range of active mobility, the time spent at work, and intraoperative complications were assessed.

Results The average active mobility obtained was 260° (230–270°). Patients resumed their normal activity within an average time of 5 weeks (between 3 and 32 weeks). There was a 6% rate of intraoperative complications and a 13% rate of postoperative complications in the metacarpals, and an 8% rate of intraoperative complications and 11% of postoperative complications in the phalanxes.

Conclusion The use of cannulated screws is a safe and effective option for the treatment of different types of fractures, obtaining a good range of mobility, early reintegration, and with an acceptable number of complications.

Keywords

metacarpal fractures - phalangeal fractures - cannulated screw

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