Purpose
This study aimed to determine the biomechanical stability of headless compression
screws in the fixation of metacarpal neck fractures and to compare them with another
common, less invasive form of fixation, K-wires. The hypothesis was that headless
compression screws would show higher stiffness and peak load to failure than K-wire
fixation.
Methods
Eight matched-paired hands (n = 31), using the ring and little finger metacarpals,
had metacarpal fractures simulated at the physeal scar. Each group was stabilized
with either a 3.5-mm headless compression screw or 2 0.045-in (1.1-mm) K-wires. Nineteen
metacarpals were tested in 3-point bending and 12 in axial loading. Peak load to failure
and stiffness were calculated from the load displacement curve. Bone mineral density
was recorded for each specimen.
Results
Bone mineral density was similar in the 2 groups tested for 3-point bending and axial
loading. Stiffness was not significantly different in 3-point bending for headless
compression screws and K-wires (means, 141.3 vs 194.5 N/mm) but it was significant
in axial loading (means, 178.0 vs 111.6 N/mm). Peak load to failure was significantly
higher in headless compression screws in 3-point bending (means, 401.2 vs 205.3 N)
and axial loading (means, 467.5 vs 198.3 N).
Conclusions
Compared with K-wires, headless compression screws for metacarpal neck fractures are
biomechanically superior in load to failure, 3-point bending, and axial loading.
Clinical relevance
Headless compression screws demonstrate excellent biomechanical stability in metacarpal
neck fractures. In conjunction with promising clinical studies, these data suggest
that headless compression screws may be an option for treating metacarpal neck fractures.
Key words
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Article info
Publication history
Published online: March 27, 2017
Accepted:
February 9,
2017
Received:
May 19,
2016
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2017 by the American Society for Surgery of the Hand. All rights reserved.
