Approach to the Adequate Choice of the Intramedullary Screw for the Treatment of Hand Bone Fractures — Radiological Study in Metacarpals and Proximal and Medial Phalanges

Abstract

Introduction One option to treat unstable and transverse fractures of the phalanges and metacarpals is intramedullary screw fixation. So far there are no references in the literature on how to choose the most appropriate screw in each case despite leaving more frequent use. However, Non-negligible complications may result in incorrect screw selection.

Material and Method One hundred radiographs were studied, in postero-anterior and oblique projection. Long fingers were measure. We were looking for the limiting measured, which is defines as the smallest dimension of the medullary in a cross-section of the bone. The limiting measure will indicate the screw that we should use.

Results A great variability was found in limiting measure. This variability was equal when studied men and women. Inverse linear regression between size of the medullar and cortical bone was observed.

Conclusions Measure the medullar of the fractured bone is an easy, fast and cheap strategy which can allow better results when we treat fractures with intramedullary screws.

Keywords

metacarpal fractures - cannulated screws - intramedullary fixation - phalangeal fractures

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