Downloads: 2
Research Paper | Orthopaedic Surgery | Volume 15 Issue 2, February 2026 | Pages: 670 - 676 | India
Functional Outcomes of Intramedullary Screw Fixation for Diaphyseal Fractures of Metacarpals and Proximal Phalanges: A Prospective Observational Study
Abstract: Background: Hand fractures involving metacarpals and phalanges account for 20-30% of all fractures. Intramedullary screw fixation has emerged as a minimally invasive option offering angular stability and early mobilization potential. Objective: To evaluate functional outcomes of intramedullary screw fixation for diaphyseal metacarpal fractures using Total Active Motion (TAM), Quick DASH (qDASH), and Rust scores, and identify factors influencing recovery. Methods: This prospective observational study included 30 patients with 47 diaphyseal metacarpal fractures treated at SMS Medical College, Jaipur. Outcomes were assessed at 4 weeks, 2 months, and 3 months using TAM score (excellent ?220°, good 180-219°, fair 140-179°, poor <140°), qDASH score, and Rust score for radiological union. Results: Mean age was 34.5±10.8 years with 90% male predominance. Fifth metacarpal was most commonly involved (34.04%), followed by fourth (25.53%), second (23.40%), and third (17.02%). Transverse fractures predominated (60%). At 3 months, 86.96% achieved excellent TAM and 13.04% achieved good TAM. The excellent TAM group demonstrated significantly lower extension lag (4.95±4.24° vs 24.16±4.91°, p<0.0001) and higher Rust scores (10.75±1.01 vs 9.83±0.75, p=0.03). Spiral fractures showed highest extension lag and lowest Rust scores. All fractures achieved union without major complications. Conclusion: Intramedullary screw fixation provides excellent functional outcomes for diaphyseal metacarpal fractures. Extension lag and Rust score significantly predict recovery. Spiral fractures and third metacarpal location require closer monitoring.
Keywords: Intramedullary Screw Fixation, Metacarpal Fracture, Total Active Motion, Rust Score, Hand Surgery
How to Cite?: Gourav Aanjna, Banisikha Das, Yash Vardhan, Vicky Kumar, Narender Saini, "Functional Outcomes of Intramedullary Screw Fixation for Diaphyseal Fractures of Metacarpals and Proximal Phalanges: A Prospective Observational Study", Volume 15 Issue 2, February 2026, International Journal of Science and Research (IJSR), Pages: 670-676, https://www.ijsr.net/getabstract.php?paperid=SR26204094452, DOI: https://dx.dx.doi.org/10.21275/SR26204094452