Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
Clinical considerations in intramedullary headless screw fixation of metacarpal and proximal phalanx fractures
Khaled M Emara, Ramy Ahmed Diab, Mohamed Hussein, Mohamed Osama Eissa, Department of Orthopedic Surgery, Ain Shams University, Cairo 11591, Egypt
Mahmoud Abuelwafa, Department of Orthopedic Surgery, Al-Azhar University, Cairo 11511, Egypt
Author contributions: Emara KM and Diab RA carried out the study conception; Eissa MO, Hussein M, and Abuelwafa M carried out the literature review and prepared the manuscript draft; Eissa MO prepared the figures and tables; Abuelwafa M, and Hussein M performed data collection, and analysis; all authors discussed and commented on the final manuscript. All authors read and approved the final manuscript.
AI contribution statement: AI-assisted language tool (Grammarly) was used solely for grammar checking and language refinement. The entirety of the main text was written by the authors. No portion of the manuscript text was AI-generated. An AI-assisted grammar and language polishing tool (Grammarly) was used to improve readability and correct grammatical errors. All intellectual content remains solely the work of the authors. No AI tool participated in the design of the study or the interpretation of its results. No images in the manuscript were generated by AI.
Conflict-of-interest statement: The authors declare no conflicts of interest related to this manuscript.
Corresponding author: Mohamed Osama Eissa, Lecturer, Department of Orthopedic Surgery, Ain Shams University, No. 38 Abbassia Street, Cairo 11591, Egypt.
Received: February 25, 2026
Revised: April 16, 2026
Accepted: May 22, 2026
Published online: July 18, 2026
Processing time: 136 Days and 11.4 Hours
Revised: April 16, 2026
Accepted: May 22, 2026
Published online: July 18, 2026
Processing time: 136 Days and 11.4 Hours
Core Tip
Core Tip: Intramedullary headless screw fixation represents a minimally invasive and mechanically reliable option for selected extra-articular metacarpal and proximal phalanx fractures, enabling early unrestricted mobilization with low complication rates. Evidence from recent meta-analyses confirms lower reoperation rates and superior Disabilities of the arm, shoulder and hand scores compared with Kirschner wires and plating. Success depends on meticulous patient selection, central guidewire technique, and structured rehabilitation. Long-term multicenter studies are needed to confirm durability and fully define indications.