Ali Said NAZLIGÜL, Nuri Koray ÜLGEN, Nihat YİĞİT, Yasin ERDOĞAN, Şahan GÜVEN, Mehmet Orçun AKKURT
Çukurova Anestezi ve Cerrahi Bilimler Dergisi - 2026;9(2):520-528
Introduction: The aim of this study was to compare the clinical and radiological outcomes of intramedullary headless compression screw fixation and plate -screw fixation in metacarpal shaft and neck fractures, and to evaluate the effectiveness of both treatment methods. Methods: Fifty -three patients (aged 18 -65) treated between June 2023 and June 2025 were retrospectively reviewed. Patients with a minimum of 6 months follow -up who were treated with either an intramedullary (IM) headless compression screw or plate -screw (PS) fixation were included in the study. Demographic data, the affected metacarpal, QuickDASH scores, grip strength, total active motion (TAM), time to return to work, time to union, and postoperative complications were recorded. Statistical significance was set at p<0.05. Results: The study evaluated 24 IM and 29 PS patients. Groups were comparable regarding demographics and fracture morphology (p>0.05). The IM group demonstrated significantly lower QuickDASH scores (p=0.029), higher grip strength (p=0.025), and greater TAM (p<0.001). Furthermore, time to return to work (p=0.001) and radiological union (p=0.045) were significantly shorter in the IM group. While deep infection and implant irritation occurred only in the PS group, complication rates were statistically similar between cohorts (p>0.05). Conclusion: The findings of this study suggest that IM screw fixation may provide better functional outcomes, along with shorter times to return to work and fracture union, compared with plate -screw fixation for extra -articular metacarpal fractures. Its minimally invasive nature and comparable safety profile make it an effective treatment option for appropriately selected patients.
