Updating and formalizing a post-operative protocol for metacarpal neck fractures treated by retrograde intramedullary screw fixation

Summary

Metacarpal neck fractures are common hand injuries, often treated surgically by fixation with a retrograde intramedullary screw. Despite the increasing use of this technique, postoperative guidelines remain variable.                                             

The purpose of this article is to present the development process and structure of a post-operative protocol dedicated to metacarpal neck fractures treated surgically with retrograde intramedullary screws.

The protocol was revised based on the literature, existing international protocols, the recommendations of the collaborating surgeon, and accumulated clinical experience. Its structure reflects the biological stages of bone healing and includes clear therapeutic objectives.

The revised protocol covers five therapeutic phases, from the inflammatory period to full reintegration into daily and professional activities. The formalization of a protocol adapted to the intramedullary screw fixation technique contributes significantly to the standardization of the therapeutic act and the optimization of functional results. This approach provides a solid basis for extending the concept to other types of fractures, such as scaphoid or distal radius fractures, with a view to developing a coherent, evidence-based, patient-centered therapeutic practice.