Intramedullary compression screw fixation in metacarpal and phalangeal fractures in athletes: a retrospective study

BACKGROUND: Metacarpal and phalangeal fractures frequently occur during athletic activities, where rapid return to activities is especially important. Among many surgical options, intramedullary compression screw fixation (IMCS) is known to impart stable fixation allowing early range of motion (ROM), improved function, and minimally invasive surgical approach. The aim of this retrospective study is to report and analyze clinical outcomes and effectiveness of IMCS in those fractures in athletes.METHODS: Sixty-four primary unstable fractures of metacarpal (N.=59) and phalanges (N.=5) treated in a single center between 2018 and 2022 have been re-evaluated. After IMCS fixation with percutaneous surgical technique, rehabilitation was immediately started; patients were encouraged to early mobilize. A clinical and radiological follow-up protocol was applied. ROM, rotational deformities, extension lag and grip strength (Jamar Test) were evaluated. Each patient was administered DASH questionnaire, VAS score, asked about return to sports and subjective satisfaction.RESULTS: All patients practiced competitive (N.=35) or recreational (N.=29) sport activities. The mean follow-up was 28 months, all fractures were healed with 129° mean ROM of metacarpophalangeal and proximal interphalangeal joints. No cases of malunion, nonunion, infection or extension lag were reported. No statistically significative difference was found in grip strength between the injured hand and the contralateral one, showing a complete recovery and the ability to return to sports in a mean time of 48±9 days from surgery.CONCLUSIONS: This technique represents a viable option for athletes or others with a premium on rapid return to function: it is minimally invasive, with early mobilization, a low rate of complications, low postoperative pain and low postoperative stiffness.