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Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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Background: Phalangeal and metacarpal fractures are the second and third most common upper extremity fractures after distal radius fractures with varying methods of fixation techniques. Intramedullary screw fixation is an increasingly preferred method of fixation. Benefits include early range of motion, faster recovery, limited dissection, and reduced complications. Improper technique, which is readily avoidable, can lead to suboptimal results. Methods: A review of recent literature on current techniques aims to summarize the biomechanics of intramedullary screw fixation and outline appropriate technique of placing headless compression screws for metacarpal and phalangeal fractures. Results: We discuss through images and videos the indications, preoperative workup, and technical pearls and pitfalls to encourage surgeons to add this technique to their armamentarium and improve outcomes. Conclusions: intrameduallry screw fixation is a powerful option for metacarpal and phalanx fixation that allows rigid stability, enabling early return of function with excellent rates of union and total active motion. With knowledge of technical pearls presented in this article, common mistakes can be avoided to improve efficiency of screw placement and optimize patient outcomes.

Background In the past 3 months, OpenAI, a San Francisco based artificial intelligence (AI) research laboratory, has released ChatGPT, a conversation large language model (LLM). ChatGPT has the ability to answer user questions, admit to mistakes, and learn from users that are accessing the program. Objectives Due to the importance of producing evidence-based research in plastic surgery, the authors of this study wanted to determine how accurate ChatGPT could be in creating novel systematic review ideas that encompasses the diverse practice of cosmetic surgery. Methods ChatGPT was given commands to produce 20 novel systematic review ideas for 12 different topics within cosmetic surgery. For each topic, the system was told to give 10 general and 10 specific ideas that were related to the concept. In order to determine the accuracy of ChatGPT, a literature review was conducted using Pubmed (National Institutes of Health, Bethesda, MD), CINAHL (EBSCO Industries, Birmingham, AL), EMBASE (Elsevier, Amsterdam, the Netherlands), and Cochrane (Wiley, Hoboken, NJ). Results A total of 240 ‘novel’ systematic review ideas were constructed by ChatGPT. We determined that the system had an overall accuracy of 55%. When topics were stratified by general and specific ideas, we found that ChatGPT was 35% accurate for general ideas and 75% accurate for specific ideas. Conclusions ChatGPT is an excellent tool that should be utilized by plastic surgeons. ChatGPT is versatile and has uses beyond research including patient consultation, patient support, and marketing. As advancements in AI continue to be made, it is important for plastic surgeons to consider the use of AI in their clinical practice.