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The headless screw was inserted obliquely to the long axis of the metacarpal bone. Headless compression screw fixation provides fixation strength similar to locked and regular plates for the fixation of metacarpal shaft fractures. Finally, the Kruskal–Wallis test was adopted to process the data, and the exact Wilcoxon rank sum test with Bonferroni adjustment was performed to conduct paired comparisons among the groups. The maximum fracture forces and stiffness values of the four fixation types were determined by observing the force–displacement curves. The specimens were tested using a modified three-point bending test on a material testing system. The entry point of the screw was in the dorsum of the metacarpal neck, and the exit point was in the volar cortex of the supracondylar region thus, the screw did not damage the articular cartilage. In the HC group, we proposed a novel fixation model in which the screw trajectory was oblique to the long axis of the metacarpal bone.

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We used a saw blade to model transverse metacarpal neck fractures in 28 fresh porcine metacarpals, which were then treated with the following four fixation methods: (1) locked plate with five locked bicortical screws (LP group), (2) regular plate with five bicortical screws (RP group), (3) two Kirschner wires (K group), and (4) a headless compression screw (HC group). We propose a modified fixation approach using headless compression screws to treat transverse or short-oblique metacarpal shaft fracture. Common complications include joint stiffness, tendon irritation, implant loosening, and cartilage damage. Current fixation options include Kirschner wire, bone plates, and intramedullary headless screws. Surgical intervention is indicated when fractures are unstable or involve considerable displacement. Metacarpal shaft fracture is a common fracture in hand trauma injuries.

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