ArticleBMC musculoskeletal disorders2021
Metacarpal shaft fixation: a biomechanical comparison of dorsal plating, lag screws, and headless compression screws.
Article in BMC musculoskeletal disorders, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 27 citations in OpenAlex.
- A Biomechanical Analysis of Intramedullary Threaded Nail Fixation and Dorsal Plate and Screw Fixation for Metacarpal Base Fractures.Journal of hand surgery global online · 2027Article
- The Effect of Retrograde Intramedullary Nail Entry at the Metacarpal Head on Metacarpophalangeal Joint Contact Mechanics.Journal of hand surgery global online · 2026Article
- Biomechanical Comparison of Plate Versus Intramedullary Screw Fixation for Extra-Articular Metacarpal Base Fractures.Journal of hand surgery global online · 2026Article
- Biomechanical Characterization of Metacarpal Fixation: Internal Load Determination and Evaluation of a Novel Adhesive Osteosynthesis.Journal of orthopaedic research : official publication of the Orthopaedic Research Society · 2025Article
- Dorsal Cortical Alignment Predicts Functional Outcomes in Proximal Phalangeal Fractures Treated with Intramedullary Headless Compression Screws but Not in Metacarpal Fractures.Journal of clinical medicine · 2025Article
- Sufficient stability using retrograde cannulated screws in a metacarpal fracture model: a biomechanical evaluation.Frontiers in bioengineering and biotechnology · 2025Article
- Biomechanical analysis of plate versus K-wire fixation for metacarpal shaft fractures with wedge-shaped bone defects.BMC musculoskeletal disorders · 2024Article
- Metacarpal Shortening with Intramedullary Screw Fixation: A Cadaveric Study.Journal of wrist surgery · 2024Article
- Outcomes Following Fully Threaded Intramedullary Nailing of Metacarpal Fractures.Journal of hand surgery global online · 2024Article
- Intramedullary K-wires versus Alternate Techniques for Metacarpal Shaft and Neck Fractures: A Systematic Review and Meta-analysis.Journal of hand and microsurgery · 2023Article
- Biomechanical study on fixation methods for horizontal oblique metacarpal shaft fractures.Journal of orthopaedic surgery and research · 2022Article
- Comparison of the fixation ability between lag screw and bone plate for oblique metacarpal shaft fracture.Journal of orthopaedic surgery and research · 2022Article
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMetacarpal shaft fractures are common and can be treated nonoperatively. Shortening, angulation, and rotational deformity are indications for surgical treatment. Various forms of treatment with advantages and disadvantages have been documented. The purpose of the study was to determine the stability of fracture fixation with intramedullary headless compression screws in two types of metacarpal shaft fractures and compare them to other common forms of rigid fixation: dorsal plating and lag screw fixation. It was hypothesized that headless compression screws would demonstrate a biomechanical stronger construct.
methodsFive matched paired hands (age 60.9 ± 4.6 years), utilizing non-thumb metacarpals, were used for comparative fixation in two fracture types created by an osteotomy. In transverse diaphyseal fractures, fixation by headless compression screws (n = 7) and plating (n = 8) were compared. In long oblique diaphyseal fractures, headless compression screws (n = 8) were compared with plating (n = 8) and lag screws (n = 7). Testing was performed using an MTS frame producing an apex dorsal, three point bending force. Peak load to failure and stiffness were calculated from the load-displacement curve generated.
resultsFor transverse fractures, headless compression screws had a significantly higher stiffness and peak load to failure, means 249.4 N/mm and 584.8 N, than plates, means 129.02 N/mm and 303.9 N (both p < 0.001). For long oblique fractures, stiffness and peak load to failure for headless compression screws were means 209 N/mm and 758.4 N, for plates 258.7 N/mm and 518.5 N, and for lag screws 172.18 N/mm and 234.11 N. There was significance in peak load to failure for headless compression screws vs plates (p = 0.023), headless compression screws vs lag screws (p < 0.001), and plates vs lag screws (p = 0.009). There was no significant difference in stiffness between groups.
conclusionIntramedullary fixation of diaphyseal metacarpal fractures with a headless compression screw provides excellent biomechanical stability. Coupled with lower risks for adverse effects, headless compression screws may be a preferable option for those requiring rapid return to sport or work. LEVEL OF EVIDENCE: Basic Science Study, Biomechanics.
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