Akademik Veri Yönetim Sistemi
Bratislava Medical Journal, cilt.126, sa.12, ss.3354-3359, 2025 (SCI-Expanded, Scopus)
Background: Phalanx fractures constitute a substantial proportion of hand fractures, and in osteosynthesis with screws for finger fractures, screw length is critical in terms of stability and soft tissue irritation. This study aims to determine the screw lengths used in plate osteosynthesis of 1st to 5th proximal phalanx fractures and compare them with corresponding bone thicknesses measured in adult cadaveric specimens. Materials and Methods: This study is retrospective observational clinical study combined with a descriptive anatomical cadaveric analysis. Patients who underwent proximal phalanx fracture fixation were retrospectively analyzed. The screw lengths used for each phalanx were recorded. Cadaveric morphometric data were obtained from 40 proximal phalanges of each digit, harvested from the bilateral hands of 20 formalin-fixed adult cadavers, and an additional 60 disarticulated proximal phalanges per digit that were not attached to cadaveric hands. Results: For the first proximal phalanx, the mean screw length was 10.27 mm (min: 9.42—max: 11.13). When compared with the mean cadaveric midshaft width of 9.67 mm, no statistically significant difference was observed between the mean screw length and the mean cadaveric midshaft width (p = 0.1471). For the second to fifth proximal phalanges, the mean screw length for this group was 9.94 mm (min: 9.61 mm—max:10.27 mm). In stark contrast to the first phalanx, the mean screw length was statistically significantly shorter than the corresponding mean cadaveric mid-shaft width of 11.90 mm (p < 0.001). In addition, a considerable percentage of these screws (35.1%) were shorter than the minimum observed cadaveric mid-shaft width of 8.21 mm. Conclusion: This study illustrates a great dichotomy between screw selection for fixation of proximal phalanx fractures. Patients' screw lengths used in the first phalanx had outstanding anatomic congruence with cadaveric measurements, yet surgeons uniformly selected much shorter screws for the second to fifth phalanges. These findings provide a critical, population-specific, evidence-based guideline to help surgeons optimize the balance between fixation stability and safety in implant selection.