CC-BY-NC-ND 4.0 · Rev Iberoam Cir Mano 2017; 45(02): 094-103
DOI: 10.1055/s-0037-1608789
Original Article | Artículo Original
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Use of Intramedullary Cannulated Headless Screws in the Treatment of Hand Fractures - An Anatomical Study on Long Fingers

Article in several languages: English | español
María Jesús Rivera Vegas
Medical Expert, Plastic, Aesthetic and Reconstructive Surgery Service, Hospital Universitario de Burgos, Burgos, Spain
,
Miguel Eugenio Estefanía Díez
Medical Expert, Plastic, Aesthetic and Reconstructive Surgery Service, Hospital Universitario de Burgos, Burgos, Spain
,
Pablo Martínez Núnez
Medical Resident, Plastic, Aesthetic and Reconstructive Surgery Service, Hospital Universitario de Burgos, Burgos, Spain
,
Rebeca Astorga Veganzones
Medical Resident, Plastic, Aesthetic and Reconstructive Surgery Service, Hospital Universitario de Burgos, Burgos, Spain
› Author Affiliations
Further Information

Publication History

12 July 2017

25 September 2017

Publication Date:
22 November 2017 (eFirst)

Abstract

Objective To quantify the cartilaginous and tendinous lesions produced upon percutaneous introduction of intramedullary cannulated screws as osteosynthesis material in metacarpal and phalangeal fractures.

Materials and Methods Seven anatomical models and one non-replanted hand were used. The measurements of 30 metacarpals and proximal and middle phalanges were taken. Cannulated screws with complete and partial threads were placed percutaneously through the metacarpal head and the proximal and middle phalanges, reproducing the actions performed in the clinic. The following measurements were performed: A) Percentage of the damaged cartilaginous area and its location. B) Damage to the extensor apparatus and its distance to the bone insertion point. C) Bone marrow size.

Results (A) The percentages of the damaged areas in the metacarpals, proximal and middle phalanges were 5.7%, 13.35% and 9.62%, respectively. (B) The damage to the extensor apparatus was less than 3 mm with a 4-mm distance to the bone insertion point and (C) We have obtained the measurements of the intramedullary bone and from them, we calculated the width of the most appropriate screw.

Conclusion In conclusion, the use of retrograde and percutaneous cannulated screws is a reliable technique with regard to the associated morbidity, and we present an approximation regarding the most appropriate screw for each location.