Cannulated percutaneous fixation of intra-articular hand fractures.

Percutaneous fixation techniques minimize edema, scar formation, and stiffness from operative trauma when restoring position and stability of displaced and unstable hand fractures. Percutaneous Kirschner wires merely splint fractures and may migrate, disengage, or irritate soft tissues; may be associated with pin tract suppuration; and may require removal at 4 to 6 weeks after insertion. Percutaneous miniscrews may provide more secure fixation for larger articular and oblique diaphyseal fractures of the thumb and finger phalanges by means of bicortical fixation and compression, are less intrusive to adjacent tissues, retain the fracture throughout the healing process, and seldom require removal. Miniscrew canulation substantially simplifies the insertion process, and headless miniscrews are entirely unobtrusive to the adjacent tissues.