Retrograde Intramedullary Headless Cannulated Screw Fixation for Unstable Metacarpal Fractures: A Longitudinal Case Series Study
Campanella S1, Chávez M2, Leal J3*, Castillo R4
¹Department of Hand and Upper Limb Reconstructive Surgery, Hospital Militar Universitario “Dr. Carlos Arvelo”, Caracas, Venezuela. ORCID: 0009-0000 1826-8302
²Postgraduate Program in Hand and Upper Limb Reconstructive Surgery, Hospital Militar Universitario “Dr. Carlos Arvelo”, Caracas, Venezuela. ORCID: 0000-0001-7425-7894
³Limb Lengthening and Deformity Correction Surgeon, Clínica Guerra Mendez, Tower D, 1st floor, office 116, Valencia, Venezuela. ORCID: 0009-0002 8083-6491 ⁴Department of Hand and Upper Limb Reconstructive Surgery, Hospital Militar Universitario “Dr. Carlos Arvelo”, Caracas, Venezuela. ORCID: 0009-0002 7338-7018
*Corresponding Author: Dr. Juan Leal, Limb Lengthening and Deformity Correction Surgeon, Clínica Guerra Mendez, Tower D, 1st floor, office 116, Valencia, Venezuela. Email: juanenrriqueleal@gmail.com Phone: +584245108142
https://doi.org/10.58624/SVOAOR.2026.06.013
Received: May 28, 2026
Published: June 24, 2026
Citation: Campanella S, Chávez M, Leal J, Castillo R. Retrograde Intramedullary Headless Cannulated Screw Fixation for Unstable Metacarpal Fractures: A Longitudinal Case Series Study. SVOA Orthopaedics 2026, 6:3, 89-95. doi: 10.58624/SVOAOR.2026.06.013
Abstract
Background: Metacarpal fractures account for a substantial portion of upper extremity skeletal trauma. Traditional percutaneous stabilization techniques, such as Kirschner wires, often require prolonged rigid external immobilization, predisposing patients to joint stiffness and chronic tendon adhesions. Retrograde intramedullary headless cannulated screws represent a minimally invasive alternative designed to deliver absolute mechanical and rotational stability.
Objective: To evaluate the clinical, radiographic, and functional outcomes of adult patients presenting with unstable extra-articular metacarpal fractures managed via retrograde intramedullary headless cannulated screw fixation.
Materials and Methods: An observational, descriptive, and retrospective longitudinal case series study was executed at the Department of Hand and Upper Limb Reconstructive Surgery of the Hospital Militar Universitario 'Dr. Carlos Arvelo', Caracas, Venezuela. A cohort of 25 adult patients (aged 20 to 60 years) treated between January 2024 and March 2025 was systematically evaluated.
Results: The study group showed a clear male predominance (84%, n=21) with a mean age of 32.4 years. The fifth metacarpal was the most frequently injured anatomical site (56%, n=14), with diaphyseal fractures accounting for 75% (n=19) of the sample. Complete radiographic bone consolidation was achieved in 100% (n=25) of the cohort, with a mean consolidation time of 6.2 weeks. Functional assessment at the final 12 week follow-up revealed an excellent mean total active range of motion (TAM) of 265°, with no reported cases of osteosynthesis material displacement, extensor tendon traction, or deep infection.
Conclusion: Retrograde intramedullary headless cannulated screw fixation constitutes a highly efficient, safe, and reproducible surgical choice for unstable extra-articular metacarpal fractures. It offers exceptional mechanical stability, avoids the need for external immobilization, and guarantees prompt, reliable functional restoration.
Keywords: Metacarpal fractures; Intramedullary screws; Headless cannulated screw; Functional recovery; Early mobilization; Hand traumatology.