Safety of intramedullary headless screw fixation for pediatric hand fractures: A systematic review

Table 1 Basic study, patients, fracture, and management characteristics of the included patients

Ref.	Country of origin	Study type	Patient number (fracture number)	Age (years)	Gender	Side	Dominant side	Fracture location	Fracture location and description	Injury to surgery time	Indication for surgery	Treatment details	Size of screws	Postoperative protocol
d’Oliveira and Craviotto[22], 2023	Uruguay	Case report	1 (2)	8	M	Right side	No	Metacarpal of the middle and ring finger	Shaft spiral fractures	NR	Spiral configuration, rotational malalignment with scissoring	Closed reduction and fixation using antegrade IMHS	30-mm length headless screw for the 4th metacarpal, and a 32-mm screw for the 3rd metacarpal. Both screws were 2.4 mm in diameter	Splint for 1 week, followed by early mobilization
Ayık et al[23], 2025	Turkey	Case series	11 (11)	9.4 (5-15)	8 M and 3 F	8 right and 3 left	8 hands	Proximal phalanx: 5 index fingers; 3 middle fingers; 2 ring fingers; and 1 little finger	4 at the neck level, 4 at the shaft, and 3 at the base	2.5 days (0-9)	Unstable fractures (rotation, shortening, or displacement), fractures involving the neck, shaft, or closed physeal base; loss of reduction after conservative treatment	Closed reduction and 7 had retrograde IMHS fixation, 4 had antegrade IMHS fixation	NR	Same day discharge- Immobilization for 3-5 days. At the 5th postoperative day, home exercises and early ROM were started under supervision by a physiotherapist
Maes et al[21], 2025	Belgium	Case report	1 (1)	12	M	Right	NR	Proximal phalanx of the ring finger	Mid-diaphyseal	4 weeks (initially treated conservatively)	Malunion with volar angulation of 50 degrees (impeding finger ROM)	Closed reduction and retrograde IMHS fixation	A cannulated compression headless screw of 2 mm diameter	A protective orthosis and buddy loop were applied, and physical therapy was initiated early

M: Male; F: Female; NR: Not reported; ROM: Range of motion; IMHS: Intramedullary headless screw.