Intramedullary Compression Screw Fixation of Proximal Phalanx Fractures: An Updated Systematic Review.

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Traumatology

Background:

• Proximal phalangeal fractures are common hand injuries with debated optimal management.
• Intramedullary screw (IMS) fixation is increasingly used to stabilize these fractures while facilitating early rehabilitation.

Purpose of the Study:

• To systematically review patient- and clinician-reported outcomes following IMS fixation for proximal phalangeal fractures.
• To provide an updated analysis of the efficacy and safety of IMS fixation in this patient population.

Main Methods:

• A comprehensive literature search was performed across major databases (PubMed, Ovid Medline, Embase, Cochrane).
• Sixteen studies involving 204 proximal phalangeal fractures treated with IMS fixation were included in the systematic review.
• Pooled analysis of functional outcome measures and complication rates was conducted.

Main Results:

• Patients achieved a mean total active motion of 237 degrees.
• Excellent functional scores were reported, with a mean Quick Disabilities of the Arm, Shoulder, and Hand (Quick-DASH) score of 3.58 and a DASH score of 2.65.
• The overall complication rate was low at 6.4%, including issues like screw prominence and infection.

Conclusions:

• Intramedullary screw fixation demonstrates good functional outcomes for proximal phalangeal fractures.
• IMS fixation is associated with a low complication rate, supporting its use for early motion and rehabilitation.