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Review
. 2025 Oct;56(4):369-374.
doi: 10.1016/j.ocl.2025.05.007. Epub 2025 Jul 8.

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

Hayden S Holbrook  1 , Matthew Wideman  2 , Mary Chase Hunter  3 , Andrew Watkins  4 , Reed W Hoyer  5 , Norfleet B Thompson  6 , James H Calandruccio  7 , F Thomas D Kaplan  5 , William J Weller  8
Affiliations
Review

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

Hayden S Holbrook et al. Orthop Clin North Am. 2025 Oct.

Abstract

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.

Keywords: Cost; Headless compression screw; K wire; Metacarpal fracture; Outcomes; Range of motion.

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Conflict of interest statement

Disclosure None of the authors have significant financial disclosures relevent to this publication. Any individual author disclosure statements can be found at AAOS.

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