Revista Espanola de Cirugia Ortopedica y Traumatologia最新文献

{"title":"[Translated article] A new dynamic technique for healing aseptic subtrochanteric hip nonunion: Detailed technique and review of literature.","authors":"A D Delgado-Martinez, E C Rodríguez-Merchán, C Zarzuela-Jiménez, H Cañada-Oya","doi":"10.1016/j.recot.2026.03.015","DOIUrl":"https://doi.org/10.1016/j.recot.2026.03.015","url":null,"abstract":"<p><strong>Background and objectives: </strong>Subtrochanteric nonunion is a challenging problem. Several techniques have been employed in the literature to address this problem, yielding varying results. The objective of this review is to present the surgical details of a new technique recently developed, and to analyze the literature about surgical techniques applied to this problem to date.</p><p><strong>Materials and methods: </strong>The detailed surgical technique of a new, dynamic system to fix subtrochanteric nonunion is presented. All literature regarding nonunion fixation of subtrochanteric nonunion was revised from 2000 to August 2025. Only papers with 2 or more patients treated by fixation of an aseptic subtrochanteric nonunion were selected. Varus and shortening correction, debridement, use of bone graft, type of device, and immediate weight bearing were searched for and analyzed in every paper.</p><p><strong>Results: </strong>347 papers were fully reviewed. 26 finally met the inclusion criteria. Varus correction was not always necessary, but when required, extramedullary systems achieved better correction. Leg shortening was overlooked by most papers, which accepted the shortening of the involved leg. Most papers use debridement and several types of bone grafts. It seems useful in atrophic nonunion, but not in hypertrophic ones. All devices but one worked in a nondynamic compression way. Most systems do not allow for immediate weight bearing, which is important for elderly people.</p><p><strong>Conclusions: </strong>The new dynamic technique for healing of subtrochanteric nonunion fulfills all the requirements to solve this problem: healing, varus and leg length correction, and immediate weight bearing. As few patients have been reported with this technique, a prospective, multicenter study is warranted and currently ongoing.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Artículo traducido] Propiedades mecánicas a la compresión de matrices porosas de ácido poliláctico generadas con impresión 3 D y esterilizadas con autoclave.","authors":"L Cucó-Sanz, M Á Tormo-Mas, J Baeza-Oliete, F F Baixauli-García, J Pemán-García","doi":"10.1016/j.recot.2026.03.014","DOIUrl":"https://doi.org/10.1016/j.recot.2026.03.014","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Three-dimensional (3 D) printing and polylactic acid (PLA) have attacted considerable interest in the medical field thanks to their versatility. 3 D printers can reproduce the microarchitecture of the designed objects and PLA has mechanical properties similar to bone. This makes the technology highly promising for personalised treatment of bone defects. In this article explores the changes to the designed object suffers after the printing, sterilisation, and its behavior when subjected to compression forces before and after autoclave sterilisation.</p><p><strong>Methods: </strong>PLA scaffolds with 3 different pore sizes were designed and 3D-printed. Half of these were autoclaved. Dimensions in all three axes were measured on sterilised and unsterilised sets of scaffolds. Then, their compressive mechanical properties were assessed in different orientations.</p><p><strong>Results: </strong>A decrease in the dimensions of the X and Y axes, as well as in the volumen, was observed in the sterilised scaffolds, while the dimensions in the Z axis increased compared to the non-sterilised ones. In the compression study, it was observed that in the non-sterilised scaffolds failed more elastically in the Z axis, with failure ocurring by accumulation of layers, but without abrupt drops in resistance. In contrast, sudden drops in load-bearing capability were observed in the sterilised scaffolds. In the X and Y axes, the scaffolds failed due to dissociation between layers. The collapse of the mechanical support was more pronounced in the sterilised scaffolds.</p><p><strong>Conclusions: </strong>According to the results of this study, 3 D printing enables the production of customised models that adhere closely to the design, with dimensional deviations of less than 1%. However, autoclave sterilisation reduces the dimensions of the X and Y axes (-4.4%) and increases those of the Z axis (+5.1%). This results in a decrease in total volume (-4.2%), which is more noticeable in scaffolds with larger pores (-6.6%). These alterations should be taken into account when designing to compensate them.Despite being stiffened and weakened by the autoclave, PLA scaffolds withstand an average compression of 320 MPa, compared to 380 MPa for unsterilised scaffolds. In the future, alloys could improve the compressive strength of PLA.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Translated article] Long-term clinical and radiological outcomes of Mayo IIA olecranon fractures treated with high-strength transosseous suture.","authors":"R García-Elvira, J A López Tello, D Martín Barreda, J Ríos Guillermo, Á Fernández-Reinales, A Combalia, P Torner","doi":"10.1016/j.recot.2026.03.007","DOIUrl":"https://doi.org/10.1016/j.recot.2026.03.007","url":null,"abstract":"<p><strong>Introduction: </strong>Olecranon fractures are common injuries, especially in the elderly population, in whom conventional osteosynthesis with tension band wiring (TBW) or plating (PF) is associated with high reoperation rates for hardware removal due to intolerance (up to 80% of surgically treated patients in the TBW group and 25% in those treated with PF). High-strength transosseous suture (TBS) has been proposed as an alternative to reduce these complications associated with conventional techniques, although few studies with long-term follow-up exist. The aim of this study was to assess, in the long term, the need for reoperation after the use of TBS in Mayo type IIA olecranon fractures in elderly patients, as well as their clinical and radiological outcomes.</p><p><strong>Materials and methods: </strong>In 2022, a previously published cohort of 29 patients operated on between 2010 and 2018 using TBS was contacted. The sex distribution was 26 women (89.7%) and 3 men (10.3%). Of these, 19 could be evaluated (12 in person and 7 by telephone), with a mean follow-up of 7.41 years (range: 4.1-11.8 years). The need for hardware removal, joint function using the Oxford Elbow Score (OES) and the Mayo Elbow Performance Score (MEPS), elbow mobility, and radiological findings were analyzed.</p><p><strong>Results: </strong>The mean age of patients at follow-up was 79 years. No patient required hardware removal. Three patients (15.8%) reported mild discomfort, but without functional impact or desire for reoperation. In the patients assessed in person, the mean range of motion was 132° flexion and 5° extension; the mean OES was 47 points and the mean MEPS was 97.1 points, with 83.3% rated as excellent outcomes. All these patients showed radiographic union without signs of post-traumatic osteoarthritis.</p><p><strong>Conclusions: </strong>The high-strength transosseous suture technique appears to be a good alternative to conventional methods, providing reliable fixation, reducing associated complications, and lowering reoperation rates for hardware removal in elderly patients.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of the D-FLLIP classification for ipsilateral floating hip and knee injuries.","authors":"M A Altamirano-Cruz, F Hernández-Aceves, S Q Rodríguez-Lara, V Giordano","doi":"10.1016/j.recot.2026.03.013","DOIUrl":"https://doi.org/10.1016/j.recot.2026.03.013","url":null,"abstract":"<p><strong>Introduction: </strong>Ipsilateral \"floating lower limb\" (FLL) -coexisting pelvic/acetabular, femoral, and tibial fractures- presents rare, high-energy trauma with complex limb-threat physiology. A standardized diagnostic framework could improve early triage and operative sequencing.</p><p><strong>Objective: </strong>To develop and preliminarily evaluate the diagnostic floating lower limb ipsilateral protocol (D-FLLIP) as an ordinal severity classification and early decision-support tool for FLL.</p><p><strong>Methods: </strong>Retrospective, single-center case series at a tertiary trauma referral hospital (January 2018 / December 2023); n=28 consecutive patients meeting FLL criteria. Study design characteristics: retrospective, informal, single-center, consecutive, exposure-based sampling (clinical); level of evidence IV. Patients were graded I-V with D-FLLIP from itemized domains (pelvis, femur, tibia, and soft-tissue/high-risk features). Primary analyses used Kruskal-Wallis and Fisher's exact/χ² to compare variables across grades. An exploratory univariable logistic regression assessed discrimination of an acute-complication composite (ICU stay >0 days, amputation, early wound infection <30 d, or significant vascular injury) with ROC/AUC estimation. Ethics approval: R-2024-1301-106; Declaration of Helsinki compliant.</p><p><strong>Results: </strong>Grade distribution: I=7 (25.0%), II=11 (39.3%), III=6 (21.4%), IV=2 (7.1%), V=2 (7.1%). Across grades, ICU length of stay and peak lactate increased stepwise (P=.0357 and P=.0128); MESS differed by grade (p=0.0264). Vascular injury and amputation were more frequent at higher grades (P≤.01), whereas early wound infection was not significant (P=.0832). The acute-complication composite rose with grade but was not statistically significant (P=.5505). Discrimination was moderate (AUC≈0.69); a pragmatic threshold grade ≥3 yielded sensitivity 0.45 and specificity 0.875.</p><p><strong>Conclusions: </strong>D-FLLIP provides a pragmatic, standardized early-severity framework for FLL, aligning with clinical gradients in ICU use, metabolic derangement, and limb-threat events. Given small, unbalanced strata -especially grades IV-V- findings are exploratory/hypothesis-generating. Prospective multicenter validation, interobserver reliability studies, and cut-off calibration are warranted to refine clinical implementation.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Translated article] Do Spanish surgeons trust hip stabilizing devices to prevent prosthetic dislocation?","authors":"N Carbó Xiqués, V Andriola, A Soler Cano, A Carballo García, A Alavedra Massana, M M Viñas Noguera, M Tey Pons","doi":"10.1016/j.recot.2026.03.010","DOIUrl":"https://doi.org/10.1016/j.recot.2026.03.010","url":null,"abstract":"<p><strong>Introduction: </strong>One of the most common complications that can occur after total hip arthroplasty (THA) is dislocation. Prosthetic dislocation is described as one of the main causes of revision surgery. After a first episode most studies conclude that conservative treatment is acceptable. However, there is no consensus on a standardised treatment to help prevent further episodes. The goal of our study was to describe the preferences and reliance in clinical practice of hip-stabilising devices among Spanish hip surgeons. It was hypothesized that no clear consensus exists among Spanish hip surgeons regarding the use of anti-dislocation devices.</p><p><strong>Material and methodology: </strong>The survey was conducted to assess use of orthopaedic immobilisations. A total of eighty-three hip surgeons from hospitals in Spain responded about the volume of THA surgeries, the incidence of dislocation and the use of orthopaedic immobilisation devices after an episode of dislocation.</p><p><strong>Results: </strong>There were 46% of surgeons who came from medium volume hospitals. The majority were senior surgeons. Up to 42% of the participants did not use any immobilization after the episode. The survey showed some variability among those who used some kind of immobilization orthosis regarding length of immobilization (from less than 2 weeks (14.6%) to more than 6 weeks (15.9%), as well as preference for different types of devices. We found no consensus on the use and trust of the device, for example 33% of surgeons who believed the orthosis ineffective affirmed they continued to use them in their clinical practice.</p><p><strong>Conclusions: </strong>There is no consensus on the use of hip stabilizing devices. The survey reveals a very heterogeneous, surgeon and center-dependent use of orthopaedic devices.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Translated article] Letter to the Editor about the article \"Fracture planning is easy: Development of a basic method of digital planning based on the traditional pencil and paper technique\".","authors":"D A Cabrera Ortiz","doi":"10.1016/j.recot.2026.03.011","DOIUrl":"https://doi.org/10.1016/j.recot.2026.03.011","url":null,"abstract":"","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of a specific learning system for minimally invasive ultrasound-guided techniques in Orthopedic Surgery and Traumatology.","authors":"J R Calvo-Tapies, J Albareda-Albareda, J Gómez-Vallejo, B Redondo-Trasobares, N Blanco-Rubio, J R Ballesteros-Betancourt, E Bueno-Gracia, P Fanlo-Mazas, I Ríos-Asín, J Pérez-Rey, J Rodríguez-Sanz, M Malo-Urriés","doi":"10.1016/j.recot.2026.03.005","DOIUrl":"https://doi.org/10.1016/j.recot.2026.03.005","url":null,"abstract":"<p><strong>Introduction: </strong>Ultrasound-guided minimally invasive techniques have experienced remarkable growth in Orthopedic Surgery and Traumatology. However, their learning process is complex, leading to the development of specific simulation models as educational tools.</p><p><strong>Objective: </strong>To evaluate the effectiveness of a personalized phantom-based training program for acquiring skills in ultrasound-guided minimally invasive techniques.</p><p><strong>Methods: </strong>A prospective comparative study was conducted with 20 orthopedic surgery residents, assigned to an intervention group (n=10; trained with phantoms) or a control group (n=10; usual training without phantom-based training). Learning transfer was assessed in a cadaver model, technical performance was evaluated using specific rubrics, and self-perceived competence was measured via questionnaires.</p><p><strong>Results: </strong>The intervention group showed a significantly shorter execution time (P<.001) and fewer attempts (P<.001). Technical performance and self-perceived competence were superior in the intervention group, with significant differences in satisfaction (P=.002), perceived effort (P=.035), and frustration (P<.001).</p><p><strong>Conclusion: </strong>Training with personalized phantoms improves technical performance and self-perceived competence in ultrasound-guided minimally invasive procedures, representing an effective and transferable tool for training in Orthopedic Surgery and Traumatology.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of median nerve transfers in high ulnar nerve injuries in adults - Scoping review.","authors":"Diego Fernando Rincón Cardozo, Jhon Fredy Castañeda López, Álvaro Antonio Kafury Goeta","doi":"10.1016/j.recot.2026.03.004","DOIUrl":"https://doi.org/10.1016/j.recot.2026.03.004","url":null,"abstract":"<p><strong>Introduction: </strong>High ulnar nerve (UN) injuries have unfavorable functional prognoses due to the limited distance for axonal regeneration. Median nerve (MN) transfer to the UN has emerged as an alternative treatment for this injury.</p><p><strong>Methods: </strong>Analysis of studies following the PRISMA-Sc guidelines was conducted. Studies evaluating MN transfer in the forearm or hand for high UN injuries between 2005 and 2025 were identified and then included. These studies included descriptions of intrinsic muscle function, grip strength (pincer or fist), and reported outcome measures. A descriptive literature review was performed.</p><p><strong>Results: </strong>Ten studies were included; given the scope of the evidence and its heterogeneity, they are presented in summary terms, without a specific comparison. Patients were primarily young adults, and the most frequent injury was laceration. The time for surgery ranged from 20 days to 18 months. Anterior interosseous nerve transfer showed functional improvements in M3 and M4 in 80% of cases, with a grip strength between 30 and 40 kg in 40% of patients. Additionally, thumb opponent muscle branch transfer resulted in a grip strength of 57% ± 16% and a terminal pinch strength of 71% ± 24% compared to the contralateral limb.</p><p><strong>Conclusions: </strong>Nerve transfer significantly improves pinch strength at M3 or higher in 80% of cases. There is insufficient evidence to recommend one procedure as superior to the other based on the results reported in the literature.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Key predictive factors in functional decline, and five-year mortality in older adults with hip fracture: a prospective cohort study from an interdisciplinary fracture unit.","authors":"D Rodríguez-Díaz, A C Tejera-Concepción, A Cabrera-Febles, N V Sánchez-Dorta, M E Fuentes-Ferrer, F J Martín-Hernández, M González-Colaço Harmand","doi":"10.1016/j.recot.2026.03.002","DOIUrl":"https://doi.org/10.1016/j.recot.2026.03.002","url":null,"abstract":"<p><strong>Background and objectives: </strong>Hip fractures in older adults constitute a clinical event with significant functional and life-threatening impact. This study aims to analyze the long-term functional evolution and mortality in patients with hip fractures treated by an interdisciplinary unit.</p><p><strong>Materials and methods: </strong>Prospective study including 300 patients admitted for hip fracture, with follow-up of mortality and functional status (Barthel Index, ambulation, Profunction) at short (1month) and long term (1, 2, 3, and 5years). Sociodemographic, clinical and nutritional variables were analyzed, along with complications and mortality during admission and up to 5years after discharge.</p><p><strong>Results: </strong>The median baseline Barthel Index score was 90points (mild dependency), declining to 70points at 2years and stabilizing at 3 and 5years, representing a 20-point loss compared with baseline. Independent ambulation increased from 4.3% at 2months to 27.5% at 5years, whereas severe dependency (bed- or chair-bound status) rose from 8.7% to 20.2%. Cognitive and nutritional impairment, the presence of delirium, and prior institutionalization were associated with poorer functional outcomes. The baseline Barthel Index score was a significant predictor of mortality.</p><p><strong>Conclusions: </strong>A comprehensive and multidimensional assessment could improve the management of patients with hip fracture, allowing the identification of risk factors for poor functional outcomes, such as cognitive impairment, social risk, malnutrition, and delirium.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional assessment in patients with metacarpal fractures treated with plates vs intramedullary screws: a scoping review.","authors":"K Quelal, E Jiménez, D J Gil Contreras, J F Castañeda","doi":"10.1016/j.recot.2026.03.001","DOIUrl":"10.1016/j.recot.2026.03.001","url":null,"abstract":"<p><strong>Introduction: </strong>Metacarpal fractures have an incidence of 8.4 per 10,000 people/year, representing 18-44% of hand fractures, and are more common in men. Various techniques have been described, such as fixation with Kirschner wires, locking plates, and intramedullary screws. The purpose of this review is to compare the functional outcomes reported in the literature.</p><p><strong>Materials and methods: </strong>A scoping review (PRISMA) was conducted, based on the PICO question: «What are the functional outcomes in patients with metacarpal fractures fixed with plates versus intramedullary screws?».</p><p><strong>Results: </strong>Five retrospective studies, one prospective study, two systematic literature reviews, and one meta-analysis were analyzed.</p><p><strong>Discussion: </strong>Kirschner wire fixation is inexpensive and readily available, requires prolonged postoperative immobilization, and is associated with a high rate of infection. The plate and screws provide the most stable fixation, require extensive soft tissue dissection, and are associated with stiffness, extensor adhesions, and infection. Screw fixation maintains reduction and prevents rotational instability, allowing for early mobilization. Joint damage does not exceed 8% of the articular surface. A total of 1,873 patients were included (295 women and 1,578 men), with a mean age of 32years. The fifth metacarpal was the most frequently fractured, and the most common fracture locations were the neck (44.66%), the shaft (38.55%), and the head (10.68%). Regarding functionality, Barrera-Ochoa, DelPrete, and Fatima reported lower QuickDASH scores for intramedullary screw fixation compared to plate fixation (8.62 vs. 4.55). Grip strength was also superior with screws (90.3% for plates, 104.4% for screws). Esteban-Feliu and Barrera report an earlier return to activity, shorter surgical time, less pain, and a lower rate of implant removal procedures in the intramedullary screw group.</p><p><strong>Conclusion: </strong>The authors conclude that intramedullary screw fixation is a safe, effective, and minimally invasive technique with satisfactory clinical results and minimal complications, offering significant functional advantages over plate fixation.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}