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Wheeless' Textbook of Orthopaedics
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ORIF of Hand Frx w/ Screws



- Indications:
    - 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.



Original Text by Clifford R. Wheeless, III, MD.