Intramedullary Fixation of Metacarpal Fractures Utilizing Retrograde Screws versus Antegrade Steinmann Pins: A Retrospective Review.

While the antegrade intramedullary pin remains a simple, inexpensive, and accessible technique with consistently favorable outcomes, retrograde headless compression screws offer a faster operative solution, with excellent radiographic alignment and low complication rates. The decision between these two implants should be individualized based on fracture pattern, implant availability, patient needs, and surgeon experience.