ORIGINAL RESEARCH article
Front. Bioeng. Biotechnol.
Sec. Biomechanics
This article is part of the Research TopicSurgical Advances in Orthopedic Trauma: A Biomechanical ApproachView all 21 articles
Sufficient stability using retrograde cannulated screws in a metacarpal fracture model: A biomechanical evaluation
Provisionally accepted
Maximilian Heilig1*
Julian Wagenhäuser2Henner Huflage3Philipp Heilig4Martin Cornelius Jordan4Rafael Gregor Jakubietz2Rainer Heribert Meffert2Stefanie Hoelscher-Doht2- 1Department of Trauma and Orthopaedic Surgery BG Unfallklinik, Frankfurt am Main, Germany
- 2Department of Orthopedic Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital Würzburg, Würzburg, Germany
- 3Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Würzburg, Germany
- 4Center for Orthopedics, Trauma Surgery and Rehabilitation Medicine Universitätsmedizin Greifswald, Greifswald, Germany
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Introduction: The treatment of metacarpal shaft fractures using cannulated compression screws has become a viable method of osteosynthesis in recent years. However, most biomechanical studies focus primarily on the ultimate failure load, comparing it to plating or K-wires. There is limited biomechanical data how cannulated compression screws perform under realistic cyclic loads encountered during postoperative physiotherapy in comparison to plating. Methods: Oblique shaft fractures were created in both porcine metatarsal and human metacarpal bones. Fractures were reduced and treated with either a partially or fully threaded cannulated compression screw or a 2.0 TriLock hand plate. Cyclic loading was then applied for 3000 cycles, ranging from 10 to 80 N, followed by an ultimate load-to-failure test. Results: The displacement after cyclic loading was lower for specimens being treated with a 2.0 TriLock hand plate compared to those treated with an intramedullary compression screw. In the subsequent load-to-failure tests, specimens with a fully threaded intramedullary screw withstood higher forces than those with a partially threaded screw or a plate. Notably, no superiority of the plate was observed in terms of ultimate loading in both porcine and human specimens. Discussion: The results indicate that using a cannulated compression screw for the treatment of metacarpal oblique fractures provides good biomechanical stability under cyclic loading. Additionally, the use of a fully threaded screw appears to increase the ultimate failure load. This study adds to the biomechanical evidence supporting the use of cannulated compression screws in the treatment of metacarpal oblique fractures. Surgeons should prioritize achieving the best and longest cortical anchorage when selecting the implant to optimize the patient’s outcome.
Keywords: Metacarpal fracture, Cannulated compression screw, plate, Implant anchorage, cyclic loading
Received: 27 Sep 2025; Accepted: 09 Dec 2025.
Copyright: © 2025 Heilig, Wagenhäuser, Huflage, Heilig, Jordan, Jakubietz, Meffert and Hoelscher-Doht. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Maximilian Heilig
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