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

Table 2 Detailed outcomes (functional, radiological, and complications) of the included patients

Ref.	Follow up period (months)	Functional outcome	Radiological outcome	Complications	Hardware removal
d’Oliveira and Craviotto[22], 2023	6	No pain - no limitation of daily activities - DASH score was zero	Adequate bony union was achieved, and no displacement or rotational malalignment	None	NR
Ayık et al[23], 2025	29.1 (24-36)	10 patients had normal finger function; 1 patient had mild restriction	Fracture union was achieved within the first month in 9 patients, and within 2 months in 2 patients. No signs of joint degeneration	None	No routine removal was recommended. One patient had a retrograde screw removal at the parents’ request
		ROM compared with the contralateral side showed the following deficits: MCP joint: 1.8 (range 0-10), PIP joint: 2.7 (range: 0-10), and DIP joint: 0.9 (range: 0-10)
		Pain VAS score of 0.09 (range: 0-1)
		Functional VAS score of 9.7 (range: 8-10)
		Aesthetic satisfaction VAS score of 9.9 (range: 9-10)
		Grip strength showed an average 10% (range: 0-20) deficit compared to the contralateral hand (tested in patients > 10 years of age)
		Overall, 10 patients had excellent outcomes, while 1 had a good outcome1
Maes et al[21], 2025	12	Full finger ROM was restored after 4 weeks postoperatively	Stable screw positioning without any signs of breakage or loosening- no degeneration at the PIP joint	None	Neither performed nor planned
		At 1 year, finger length growth was normal - no pain - full ROM in all fingers and a symmetrical power grip

¹According to the author’s definition: Excellent outcome if there was complete restoration of normal finger function. Good outcome when both the patient and the surgeon are satisfied; the affected joint has only mild restriction, with no residual deformity.

DASH: Disabilities of the arm, shoulder, and hand; NR: Not reported; VAS: Visual analog scale; ROM: Range of motion; PIP: Proximal interphalangeal joint; DIP: Distal interphalangeal joint; MCP: Metacarpophalangeal joint.