gms | German Medical Science

Objectives/Interrogation: The surgical management of metacarpal and phalangeal fractures is commonly with Kirschner wire and plate and screws, which may cause scarring and adhesions leading to poor functional outcomes. Intramedullary headless screw fixation can be a viable alternative with better outcomes. The aim is to present our institution's early experience on the outcomes of metacarpal and phalangeal fractures surgically fixed with intramedullary headless screws

Methods: We retrospectively reviewed clinical data of patients who had metacarpal and phalangeal fractures fixed with intramedullary headless screws at our institution from January 2018 - August 2018. A total of 6 patients were identified. They were all male, all right handed, all work permit holders with an average age of 31. Five were labourers who were involved in an industrial accident while 1 was a technician who was involved in a road traffic accident.

Results and Conclusions: There were 2 proximal phalanx fractures, 1 middle phalanx fracture and 3 metacarpal fracture, and a single screw was used in all. Two patients had previous fixation of their fracture with plates and screws - 1 patient had removal of implants as his fixation was complicated by painful non-union and poor range of movement, while the other patient had peri-implant fracture. Subsequently, their fractures were surgically fixed with intramedullary headless screws.

At latest follow up, total average range of motion was 128. In 3 patients, fractures were healed and within acceptable radiological parameters. None of the patients have post-operative complications thus far at follow-up.

All patients are still on active follow-up, with ongoing hand occupational therapy. Patient satisfaction, quickDASH score, time to return to normal activities and work have yet to be determined.

Intramedullary headless screw fixation is a reliable alternative to metacarpal and phalangeal fractures.