Purpose
There has been a recent increase in the use of intramedullary screws (IMS) for the
surgical treatment of metacarpal fractures. While IMS fixation has been shown to produce
excellent functional outcomes, postoperative complications have yet to be fully explored
in a comprehensive way. This systematic review quantified the incidence, treatment,
and results of complications following IMS fixation for metacarpal fractures.
Methods
A systematic review was performed using PubMed, Cochrane Central, EBSCO, and EMBASE
databases. All clinical studies that documented IMS complications following metacarpal
fracture fixation were included. Descriptive statistics were analyzed for all available
data.
Results
Twenty-six studies were included: 2 randomized trials, 4 cohort studies, 19 case series,
and 1 case report. Among the 1,014 fractures studied, 47 complications were reported
across all studies (4.6%). Stiffness was the most common, followed by extension lag,
loss of reduction, shortening, and complex regional pain syndrome. Other complications
included screw fracture, bending, and migration; early-onset arthrosis; infection;
tendon adhesion; hypertrophic scar; hematoma; and nickel allergy. Eighteen of the
47 (38%) patients with complications underwent revision surgery.
Conclusions
Complications following IMS fixation of metacarpal fractures are relatively uncommon.
Type of study/level of evidence
Therapeutic IV.
Key words
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Article info
Publication history
Published online: March 04, 2023
Accepted:
January 4,
2023
Received:
August 30,
2022
Publication stage
In Press Corrected ProofFootnotes
C.M.J. receives funding from ExsoMed. No benefits in any form have been received or will be received by the other authors related directly to this article.
Identification
Copyright
© 2023 by the American Society for Surgery of the Hand. All rights reserved.
