Unraveling of cannulated screw threads during fixation of medial epicondyle humerus fractures in adolescents: short communication

Cannulated screws have significant advantages, including ease of insertion and increased accuracy, during fracture fixation. Unraveling of screw threads is an uncommon complication related to cannulated screws. This single-institution case series aims to highlight four cases of unraveling of cannulated screw threads during the fixation of medial epicondyle humerus fractures in adolescents. All four cases involved the use of 4.0 or 4.5 mm partially threaded cannulated screws from the same manufacturer. This phenomenon was replicated in two cadaveric humeri. The higher density of bone on the lateral aspect of the medial column of the distal humerus would likely contribute to this complication. Modifying the surgical technique to include predrilling prior to screw placement can potentially avoid this complication.