Arthrex carries an extensive line of titanium screws. The titanium Compression FT (fully-threaded) screws come in 2.5 Micro, 3.5 Mini, and 4.0 Standard. The variable stepped thread pitch, headless design reduces the risk of profile complications, provides compression and allows for simplified insertion.

Hand and Wrist

Product

Procedure

New Snap-Off Compression FT pins offer solutions for extremities and the trauma setting. The ease of use, variable-stepped thread pitch, and wide range of sizes in diameters of 1.9 mm and 2.4 mm represent an innovative new technology to use in joint arthrodesis and for repair and reconstruction of intra-articular and extra-articular fractures. They offer compression of bone fragments for a wide range of indications and can be used in conjunction with other Arthrex products.

Snap-Off Compression FT Pins

Human

Child (D)

The titanium Compression FT (fully threaded) screws come in 2.5 Micro, 3.5 Mini, and 4.0 Standard. The variable-stepped thread pitch headless design reduces the risk of profile complications, provides compression, and allows for simplified insertion. Surgeons can now achieve zero-profile, stable fixation.

Michael J. Garcia, MD, (Tampa, FL) presents metacarpal fracture fixation using an intramedullary, partially threaded Compression PT Screw.

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Intramedullary Screw Fixation for Metacarpal Fractures

We're going to talk about using an intramedullary screw, a headless screw, for fixation of a actually stable metacarpal fracture. It's a technique that allows for stable internal fixation without the need for external prominent hardware. We begin by visualizing the fracture via radiograph, so that we can determine the pattern of the fracture and the screw placement, so that we can maintain reduction and allow for an appropriate reduction and fixation of the fracture with the intramedullary screw. Once this is completed, a small incision is made dorsally over the metacarpophalangeal joint, taking care to visualize the extensor tendons in the small finger. I prefer to go between the two extensor tendons to the small finger to expose the metacarpal head. Blunt dissection is used to identify the extensor mechanism over the metacarpophalangeal joint, and either a onnalee based approached or centrally based approach is made to the metacarpal head. Once the extensor mechanism is visualized, the knife is used to open the extensor mechanism and expose the metacarpal head. This may or may not be repaired at the end of the surgery. Once the metacarpal head is identified, the finger is flexed and the fracture is reduced and confirmed to be reduced via fluoroscopic imaging. At this point, a wire is introduced across the fracture site centrally in the metacarpal head and dorsally in line with the Diaphyseal canal. Here you can see the key wire introduced across the fracture site. Maintaining the reduction of the fracture in an appropriate position both on the AP and lateral view. The goal of the wire placement is to be dorsally in the metacarpophalangeal joint and in the metacarpal head. This will allow for minimal disruption of the articular cartilage in the metacarpal head, and to prevent any long term late effects of applying the screw in a retrograde fashion. The next step will be to open the entry point for the screw via the drill. The drill only needs to be introduced a couple of millimeters into the metacarpal head, so as to allow for passage of the screw. Care is taken to make sure the wire does not exit with the drill. At this point, the longest 3.0 Herbert screw is placed over the wire and then, while maintaining appropriate rotational alignment as the screw advances, you should feel an excellent diaphyseal bite of the leading screw threads as it's introduced across the fracture, providing you with stable fixation of the metacarpal with a minimally invasive, small near percutaneous approach. By making the small incision, you're able to visualize the metacarpal head and to assure that the screw is sunk into the metaphysis below the articular cartilage to prevent articular cartilage injury, the wire is removed. So at this point now the finger is assessed for rotational alignment and relative to the digital cascade of the other digits. As you can see in these fluoroscopic images, the screw has been sunk 1 to 2mm below the articular cartilage. The fracture is well aligned and maintained via the intramedullary screw, and the screw has shown good compression at the fracture site to increase stability of the fracture. Post-op protocol for the patient involves a simple, small hand based splint from the operating room. In early follow up with an occupational therapist for being fit with a thermoplastic ulnar gutter. Hand based splint. Early active. Active assisted range of motion has begun on post-op day 1 or 2 to maximize their early return to function.

This animation demonstrates the technique for intramedullary screw fixation with a Compression FT screw for a transverse metacarpal fracture.

Compression FT Intramedullary FX Fixation

A small incision is made dorsally over the metacarpophalangeal joint. The metacarpal head is visualized. The joint is flexed and the fracture is reduced. The guidewire is introduced across the fracture site, starting in the dorsal one third of the metacarpal head and aiming down the canal. A cannulated drill over drills the guidewire and the wire remains in the bone. The cannulated screw is placed over the wire, obtaining fixation across the fracture site. The screw should be countersunk 1 to 2mm below the articular cartilage.

Compression FT Screws

The QuickFix™ Cannulated Screw System is a comprehensive set for fixation of the foot, ankle, hand, wrist, and elbow. The screws are cannulated, partially threaded, titanium alloy and are indicated for use in bone reconstruction, osteotomy, arthrodesis, joint fusion, fracture repair, and fracture fixation of bones appropriate for the size of the device. The QuickFix Screw System provides extensive versatility for surgical procedures of the foot all-in-one system. 

Complete Set – Full range of partially threaded, titanium, self-drilling and self-tapping cannulated screw options, in 2, 2.4, 3 and 4 mm diameters.
Best Material – Titanium screws with Type II anodization to provide consistent strength, biocompatibility, and superior post-op imaging.
Novel Instrumentation – Triple Plays (all-in-one near cortex drill, Countersink, and Depth Device) were designed to reduce OR time.
Easy to Use – Color-coded implant and instrument tray saves OR time.
Hexalobe Drive – Superior driver engagement – less potential for screw stripping.

Metal Screws

Snap-Off Compression FT Pins

Compression FT Screws

QuickFix™ Cannulated Screw Set