Intramedullary headless screw fixation of extraarticular metacarpal and proximal phalanx fractures, North African trauma center early experience

doi:10.5312/wjo.v17.i4.115014

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Apr 18, 2026 (publication date) through Apr 17, 2026

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World Journal of Orthopedics

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2218-5836

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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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.

World J Orthop. Apr 18, 2026; 17(4): 115014
Published online Apr 18, 2026. doi: 10.5312/wjo.v17.i4.115014

Table 1 Basic patient demographics, nature of injury, fracture characteristics, and operative details, n (%)/mean ± SD (range)

		Total of 53 patients (67 fractures)	Group A (n = 38 patients) (51 fractures)	Group B (n = 15 patients) (16 fractures)	P value for comparisons between group A vs group B
Age (years)		33.79 ± 12.69 (17-65)	35.08 ± 13.04 (17-60)	32.53 ± 12.17 (19-65)	0.517
Sex	Male	47 (88.68)	35 (92.11)	12 (80)	0.334
Sex	Female	6 (11.32)	3 (7.89)	3 (20)	0.334
Frequency	Multiple fracture	12 patients	24 (47.06) (11 patients)	2 (12.5) (1 patient)	0.002^a
Frequency	Single fracture	41 patients	27 (52.94) (27 patients)	14 (87.5) (14 patients)	0.144
Side of fracture	Right hand	27 (50.94)	20 (52.63)	7 (46.67)	0.766
	Left hand	26 (49.06)	18 (47.37)	8 (53.33)	0.766
	Dominant hand	45 (84.9)	34 (89.47)	11 (73.33)	0.202
Mode of trauma	MCA	14 (26.42)	11 (28.95)	3 (20)	0.732
	HOT	1 (1.89)	1 (2.63)	0 (0)	1.000
	FOG	22 (41.51)	14 (36.84)	8 (53.33)	0.357
	MBA	4 (7.55)	3 (7.89)	1 (6.67)	1.000
	AFO	12 (22.64)	9 (23.68)	3 (20)	1.000
Associated injuries	Radius fracture	1 (1.89)	1 (2.63)	0 (0)	1.000
	Ulna fracture	3 (5.66)	3 (7.89)	0 (0)	0.550
	Lunate fracture	1 (1.89)	1 (2.63)	0 (0)	1.000
	Femur fracture	2 (3.77)	1 (2.63)	1 (6.67)	0.490
	Tibia fracture	2 (3.77)	1 (2.63)	1 (6.67)	0.490
	Spine fracture	1 (1.89)	0 (0)	1 (6.67)	0.283
Fractures characteristics
Fractures location	1^st	0 (0)	0 (0)	0 (0)	1.000
	2^nd	11 (16.42)	7 (13.73)	4 (25)	0.438
	3^rd	9 (13.43)	7 (13.73)	2 (12.5)	1.000
	4^th	20 (29.85)	16 (31.37)	4 (25)	0.760
	5^th	27 (40.30)	21 (41.18)	6 (37.5)	1.000
Fracture pattern	Spiral	11 (16.42)	10 (19.61)	1 (6.25)	0.274
	Oblique	15 (22.39)	10 (19.61)	5 (31.25)	0.327
	Comminuted	20 (29.85)	17 (33.33)	3 (18.75)	0.356
	Transverse	21 (31.34)	14 (27.45)	7 (43.75)	0.234
Anatomical site	Diaphysis	42 (62.69)	34 (66.67)	8 (50)	0.251
Anatomical site	Metaphysis	25 (37.31)	17 (33.33)	8 (50)	0.251
Operative details
Anaesthesia	General	20 (29.85)	17 (33.33)	3 (18.75)	0.356
Anaesthesia	Wideawake	47 (70.15)	34 (66.67)	13 (81.25)	0.356
Operative time (minutes)		14.37 ± 3.46 (10-30)	14.43 ± 3.81 (10-30)	14.19 ± 2.07 (11-19)	0.747
Fracture Reduction	Open	3 (4.48)	3 (5.88)	0 (0)	1.000
Fracture Reduction	Closed	64 (95.52)	48 (94.12)	16 (100)	1.000
Type of screw	Acutrak 4 mm (fully threaded)	38 (56.72)	31 (60.78)	7 (43.75)	0.260
	Herbert 3.5 (partially threaded)	18 (26.87)	12 (23.53)	6 (37.5)	0.336
	Herbert 2.7 (partially threaded)	11 (16.42)	8 (15.69)	3 (18.75)	0.716

^aP values < 0.05 indicate statistical significance.

MCA: Motor car accident; HOT: Heavy object trauma; FOG: Fall on ground; MBA: Motor bike accident; AFO: Assault from others.

Full Size Table

Table 2 Radiological, functional, and complications outcomes, n (%)/mean ± SD (range)

		Total of 53 patients (n = 67 fractures)	Group A (n = 38 patients) (n = 51 fractures)	Group B (n = 15 patients) (n = 16 fractures)	P value for comparisons between group A vs group B
Time till fracture union (weeks)		5.62 ± 0.99 (4-8)	5.57 ± 0.94 (4-8)	5.68 ± 1.04 (5-8)	0.706
Last follow up (days)		101.19 ± 52.31 (60-350)	102.06 ± 53.92 (60-350)	98.43 ± 48.31 (60-244)	0.812
ROM MCPJ 85 (°)		82 ± 1.9 (65-85)	82.92 ± 2.97 (65-85)	79.88 ± 5.44 (65-85)	0.033
ROM PIPJ 110 (°)		107.4 ± 4.93 (87-110)	108.49 ± 2.76 (95-110)	102.63 ± 7.19 (87-110)	0.001^a
ROM DIPJ 65 (°)		63.84 ± 2.66 (50-65)	64.22 ± 2.32 (55-65)	61.43 ± 3.81 (50-65)	0.006^a
TAM (°)		253.15 ± 10.29 (202-260)	255.14 ± 9.11 (223-260)	244.31 ± 15.12 (202-260)	0.007^a
Extension lag		2.53 ± 3.77 (0-20.2)	1.15 ± 2.08 (0-13.8)	2.01 ± 1.74 (0-6.2)	0.100
Hand grip strength (% of the contralateral side)		98.66 ± 1.31 (92.2 to 99.8)	98.84 ± 1.07 (92.2-99.8)	98.11 ± 1.8 (93.5-99.7)	0.124
QuickDASH score		15.08 ± 11.95 (2-57)	2.9 ± 4.99 (0-34)	6.88 ± 9.32 (0-34)	0.030^a
VAS score		0.69 ± 1.10 (0-5)	0.35 ± 0.77 (0-3)	1.94 ± 1.57 (0-5)	< 0.001^a
Complications	Infection	0 (0.00)	0 (0)	0 (0)	1.000
	Nonunion	0 (0.00)	0 (0)	0 (0)	1.000
	Shortening with metal protrusion	2 (2.99)	1 (1.96)	1 (6.25)	0.423
	Shortening without metal protrusion	2 (2.99)	1 (1.96)	1 (6.25)	0.423
	Malunion	1 (1.49)	0 (0)	1 (6.25)	0.239

^aP values < 0.05 indicate statistical significance.

ROM: Range of motion; MCPJ: Metacarpophalangeal joint; PIPJ: Proximal interphalangeal joint; DIPJ: Distal interphalangeal joint; TAM: Total active motion; QuickDASH: Quick Disabilities of the Arm, Shoulder, and Hand; VAS: Visual analogue score.

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Citation: Saleh WR, Khalifa AA, Ragheb YF, El-Sayed A, Megahed AA. Intramedullary headless screw fixation of extraarticular metacarpal and proximal phalanx fractures, North African trauma center early experience. World J Orthop 2026; 17(4): 115014
URL: https://www.wjgnet.com/2218-5836/full/v17/i4/115014.htm
DOI: https://dx.doi.org/10.5312/wjo.v17.i4.115014