To evaluate the effect of headless compression screw technique and mini-plate technique in the treatment of metacarpal and phalangeal fractures.

The English databases PubMed, Web of Science and Chinese databases CNKI, VIP and WanFang Data were searched for the clinical trial literatures about the comparison of the fixation effects of headless compression screws and mini-plates after metacarpal and phalangeal fractures from January 2013 to December 2023. At the same time, the magazine catalogue and references were searched manually. The operation time, fracture healing time, excellent postoperative recovery of hand function, postoperative infection andpostoperative tendon adhesion were analyzed by Review Manager 5.4 software.

A total of 9 articles were included in this study, including 2 in English and 7 in Chinese. The operation time (SMD=-1.37, 95% CI: -1.68, -1.06, P<0.01) and fracture healing time (SMD=-1.33, 95% CI: -2.12, -0.54, P<0.01) of the headless compression screw technique were shorter than those of the mini-plate technique, and the postoperative hand function recovery of the headless compression screw technique was better than that of the mini-plate technique (OR=5.39, 95% CI: 2.17, 13.39, P<0.01). In terms of postoperative complications, the incidence of postoperative infection was similar between the two groups (OR=1.28, 95% CI: 0.48, 3.42, P=0.62), but the incidence of postoperative tendon adhesion (OR=0.07, 95% CI: 0.03, 0.20, P<0.01) was significantly less than those of mini-plate technique.

In the treatment of metacarpal and phalangeal fractures, headless compression screw technique is superior to mini-plate technique in operation time, fracture healing time, postoperative hand function recovery and complications for patients with metacarpal and phalangeal fractures with suitable indications, headless compression screw technology can replace minimally invasive plate technology as the first choice.