Abstract
Background
Metacarpal and proximal phalangeal fractures constitute 55% of all hand fractures, with stable cases often managed conservatively. Unstable fractures, however, require surgical intervention, utilizing methods such as K-wires, screws, and plates. Intramedullary cannulated headless compression screws (IHCS) are a promising option, allowing percutaneous application and early mobilization, which is crucial for reducing recovery time.
Methods
This study retrospectively reviewed patients who underwent IHCS fixation from October 2021 to January 2023, approved by the local ethics committee. Exclusion criteria included tendon or nerve injuries and follow-up of less than six months. Acute or malunited fractures of metacarpals and proximal phalanx were included. Nineteen fingers from thirteen patients were analyzed. Demographics, functional outcomes, and complications were recorded.
Results
Patients returned to work or school in an average of 15.4 days. Total active movement (TAM) was assessed at three months, with a mean of 222.5 degrees. Eleven patients achieved good results, while two had poor outcomes; both patients underwent revision surgery, resulting in improved TAM. No clinical malunion or nonunion was observed, and extension lag was absent.
Conclusion
The findings suggest that IHCS provides effective fixation for both phalanx and metacarpal fractures, facilitating early active motion and minimizing complications associated with other surgical techniques. Nonetheless, the results support the use of IHCS in treating malunited fractures and indicate its potential for further investigation in larger cohorts.

Key words: metacarpal fracture, phalanx fracture, intramedullary screw