Comparison of Screw Lengths Used in Surgically Treated Proximal Phalanx Fractures with Anatomical Cadaveric Data: A Morphometric Analysis
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background: 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: 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, comparison showed no statistically significant difference between the average surgical screw length and the average cadaveric mid-shaft width. In sharp contrast, for the second to fifth phalanges, which were treated as a consolidated group, the average screw length was statistically significantly shorter than the average cadaveric mid-shaft width. 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.
Institutions: Ankara Bilkent City Hospital, Ankara University
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,590
OpenAlex ID: W4415518151