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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 Clin Pediatr. Dec 9, 2026; 15(4): 120900
Published online Dec 9, 2026. doi: 10.5409/wjcp.120900
Safety of intramedullary headless screw fixation for pediatric hand fractures: A systematic review
Ahmed A Khalifa, Ahmed A Megahed, Ahmad Imran
Ahmed A Khalifa, Department of Orthopaedic, Qena Faculty of Medicine and University Hospital, South Valley University, Qena 83523, Qina, Egypt
Ahmed A Khalifa, Ahmad Imran, Department of Orthopedic, Aster Sanad Hospital, Riyadh 13216, Riyadh, Saudi Arabia
Ahmed A Megahed, Department of Orthopaedic and Traumatology, Assiut University Hospital, Assiut 71515, Egypt
Author contributions: Khalifa AA conceptualized the study, performed data analysis, and critically revised the manuscript; Megahed AA and Imran A collected and extracted data; Khalifa AA, Megahed AA, and Imran A conducted the literature review, prepared the initial manuscript draft, and designed the tables; all authors discussed, commented on, read and approved the final manuscript.
Conflict-of-interest statement: The authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Corresponding author: Ahmed A Khalifa, MD, Assistant Professor, FRCS, Department of Orthopaedic, Qena Faculty of Medicine and University Hospital, South Valley University, Kilo 6 Qena-Safaga Highway, Qena 83523, Qina, Egypt. ahmed_adel0391@med.svu.edu.eg
Received: March 11, 2026
Revised: April 5, 2026
Accepted: June 1, 2026
Published online: December 9, 2026
Processing time: 192 Days and 13.6 Hours
Core Tip

Core Tip: Pediatric hand fractures are primarily treated with conservative approaches using immobilization, with acceptable outcomes. A subset of these fractures is amenable to operative management, especially those with malalignment or displacement, or when conservative management fails. Closed reduction and fixation using intramedullary headless screws (IMHS) is an operative management option that has proven efficacy in adults. Although the current systematic review included a small number of patients, IMHS fixation of pediatric metacarpal or proximal phalanx fractures resulted in excellent functional outcomes, 100% union rate, and 0% complications. These early results are encouraging and suggest that IMHS should be considered for operative management of pediatric hand fractures.

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