Assessing Osteoarthritis Risk After Retrograde Intramedullary Headless Screw Fixation for Metacarpal Fractures: A Minimum Six-Year Follow-Up Study.

PURPOSE: Retrograde intramedullary headless screws are increasingly used for metacarpal fractures, but concerns regarding long-term complications, such as metacarpophalangeal osteoarthritis, persist. This study evaluated osteoarthritic changes following this fixation method.

METHODS

A retrospective analysis of 41 patients treated with retrograde intramedullary headless screws between 2014 and 2018 was conducted, with a minimum follow-up of 72 months. Fracture healing and joint changes were evaluated through radiographs and computed tomography.

RESULTS

At a mean follow-up of 87 months, no osteoarthritic changes or chondrolysis were observed on radiographs or computed tomography scans. The screw affected an average of 17.5% of the metacarpal head's articular surface, with no evidence of erosion over time. Two early postoperative complications related to fracture treatment (one hardware failure and one malunion) occurred, both unrelated to osteoarthritic changes and without impact on long-term outcomes.

CONCLUSIONS

Retrograde intramedullary headless screw fixation is not associated with long-term osteoarthritic changes over a 6-year follow-up.

TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.