- displaced long oblique fractures, spiral frxs, or articlar fractures (> 25%) of metacarpals or phalanges;
- screw fixation used w/o a plate, requires that the frx length will be at least twice diameter of the metacarpal; (lag screw theory)
- a minimum of 2 screws are used; - Size of Implants:
- 2.7 mm screws are best used in metacarpal base and, in large adults, in the metacarpal shafts;
- smaller metacarpals: 2.0 mm screws are used; - phalanges: 1.5 mm screws are used
Fixation of hand fractures with bicortical screws.