Abstract
Objective To quantify the cartilaginous and tendinous lesions produced upon percutaneous introduction
of intramedullary cannulated screws as osteosynthesis material in metacarpal and phalangeal
fractures.
Materials and Methods Seven anatomical models and one non-replanted hand were used. The measurements of
30 metacarpals and proximal and middle phalanges were taken. Cannulated screws with
complete and partial threads were placed percutaneously through the metacarpal head
and the proximal and middle phalanges, reproducing the actions performed in the clinic.
The following measurements were performed: A) Percentage of the damaged cartilaginous
area and its location. B) Damage to the extensor apparatus and its distance to the
bone insertion point. C) Bone marrow size.
Results (A) The percentages of the damaged areas in the metacarpals, proximal and middle
phalanges were 5.7%, 13.35% and 9.62%, respectively. (B) The damage to the extensor
apparatus was less than 3 mm with a 4-mm distance to the bone insertion point and
(C) We have obtained the measurements of the intramedullary bone and from them, we
calculated the width of the most appropriate screw.
Conclusion In conclusion, the use of retrograde and percutaneous cannulated screws is a reliable
technique with regard to the associated morbidity, and we present an approximation
regarding the most appropriate screw for each location.
Keywords
metacarpals - phalanges - osteosynthesis - intramedullary screws
