Open AccessIntramedullary compression screw fixation of metacarpal and phalangeal fractures
Author(s) -
Marco Enrico Luigi Guidi,
Florian S. Frueh,
Inga S. Besmens,
Maurizio Calcagni
Publication year - 2020
Publication title -
efort open reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.588
H-Index - 22
ISSN - 2396-7544
DOI - 10.1302/2058-5241.5.190068
Subject(s) - intramedullary rod , medicine , fixation (population genetics) , metacarpal bones , surgery , kirschner wire , orthodontics , internal fixation , population , environmental health
The intramedullary headless compression screw (IMCS) technique represents a reliable alternative to percutaneous Kirschner-wire and plate fixation with minimal complications. Transverse fractures of the metacarpal shaft represent a good indication for this technique. Non-comminuted subcapital and short oblique fractures can also be treated with IMCS. This technique should not be used in the presence of an open epiphysis, infection and, most of all, in subchondral fractures, because of the lack of purchase for the head of the screw. A double screw construct is recommended for comminuted subcapital fractures of the metacarpal to avoid metacarpal shortening. IMCS can even be applied for peri-articular fractures of the proximal third of the phalanx and in some multi-fragmentary proximal and middle phalangeal fractures. Usually the intramedullary screws are not removed. The main indications for screw removal are joint protrusion, infection and screw breakage after new fracture. Cite this article: EFORT Open Rev 2020;5:624-629. DOI: 10.1302/2058-5241.5.190068