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Background <p>Intramedullary headless compression screw fixation has gained increasing popularity for the surgical treatment of metacarpal fractures owing to its minimally invasive nature and potential for early mobilisation without prolonged postoperative immobilisation. However, comprehensive data on clinical and radiological outcomes remain limited.</p> Methods <p>This retrospective study included patients with metacarpal shaft or neck fractures treated with retrograde intramedullary headless screw fixation. No postoperative immobilisation was applied, and early active mobilisation was initiated in all patients on the day of surgery. Demographic data, fracture characteristics, operative details, pre- and postoperative angulation, radiological union time, functional outcomes, QuickDASH score, and complications were recorded. Preoperative and postoperative angulation values were compared using a paired Student’s t-test.</p> Results <p>A total of 37 patients were included, with a mean age of 37.5 ± 15.4 years. The majority of fractures involved the fifth metacarpal (70.3%). The most common mechanisms were direct impact/blunt trauma and falls. Mean operative time was 12.8 ± 3.9&#xa0;min (range, 7–21&#xa0;min). Mean preoperative angulation of 41.2° ± 12.2 improved significantly to 0.2° ± 0.71 postoperatively (<i>p</i> &lt; 0.001). Mean radiological union time was 5.6 ± 0.8 weeks (range, 4–7 weeks). At final follow-up, all evaluable patients had achieved full functional recovery, with a mean QuickDASH score of 10.3 ± 7.8 (range, 0.0–27.3). Minor complications occurred in two patients (5.4%), both of whom required implant removal following radiological union.</p> Conclusion <p>Retrograde intramedullary headless compression screw fixation provides reliable clinical and radiological outcomes for metacarpal fractures, enabling splint-free early mobilisation with effective deformity correction, a low complication rate, and favourable functional recovery. This technique represents a safe and effective surgical option in appropriately selected patients.</p>

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Intramedullary headless compression screw fixation for metacarpal fractures: a retrospective clinical and radiological study

  • 期刊论文

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  • 发表日期：

    2026年4月17日

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  • Burak Kuşcu,
  • Mustafa Kınaş

摘要

Background

Intramedullary headless compression screw fixation has gained increasing popularity for the surgical treatment of metacarpal fractures owing to its minimally invasive nature and potential for early mobilisation without prolonged postoperative immobilisation. However, comprehensive data on clinical and radiological outcomes remain limited.

Methods

This retrospective study included patients with metacarpal shaft or neck fractures treated with retrograde intramedullary headless screw fixation. No postoperative immobilisation was applied, and early active mobilisation was initiated in all patients on the day of surgery. Demographic data, fracture characteristics, operative details, pre- and postoperative angulation, radiological union time, functional outcomes, QuickDASH score, and complications were recorded. Preoperative and postoperative angulation values were compared using a paired Student’s t-test.

Results

A total of 37 patients were included, with a mean age of 37.5 ± 15.4 years. The majority of fractures involved the fifth metacarpal (70.3%). The most common mechanisms were direct impact/blunt trauma and falls. Mean operative time was 12.8 ± 3.9 min (range, 7–21 min). Mean preoperative angulation of 41.2° ± 12.2 improved significantly to 0.2° ± 0.71 postoperatively (p < 0.001). Mean radiological union time was 5.6 ± 0.8 weeks (range, 4–7 weeks). At final follow-up, all evaluable patients had achieved full functional recovery, with a mean QuickDASH score of 10.3 ± 7.8 (range, 0.0–27.3). Minor complications occurred in two patients (5.4%), both of whom required implant removal following radiological union.

Conclusion

Retrograde intramedullary headless compression screw fixation provides reliable clinical and radiological outcomes for metacarpal fractures, enabling splint-free early mobilisation with effective deformity correction, a low complication rate, and favourable functional recovery. This technique represents a safe and effective surgical option in appropriately selected patients.