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Two Parallel Headless Compression Screws for Scaphoid Fractures: Radiographic Analysis and Preliminary Outcome
Eliseo V DiPrinzio1, James D Dieterich1, Amanda L Walsh1
1Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Hand (New York, N.Y.)
|April 11, 2022
Summary
A two-screw fixation technique for scaphoid fractures shows a high union rate and good clinical outcomes. This method offers consistent screw placement regardless of patient gender or body size.
Area of Science:
- Orthopedic surgery
- Traumatology
- Biomedical engineering
Background:
- Scaphoid nonunion rates persist between 3% and 5% despite surgical fixation.
- Biomechanical studies suggest 2-screw constructs enhance stability.
- This study evaluates a novel 2-screw fixation technique for scaphoid fractures.
Purpose of the Study:
- To determine the preliminary union rate of 2-screw surgical fixation for scaphoid fractures.
- To assess the anatomic feasibility of the 2-screw technique.
- To evaluate clinical outcomes including union time and functional scores.
Main Methods:
- Retrospective case series of 25 patients with scaphoid fractures.
- Treatment involved 2 parallel headless compression screws (HCS).
- Evaluated Mayo Wrist Score (MWS), range of motion, time to union, and return to activity.
Main Results:
- All fractures achieved union, averaging 9.9 weeks.
- Mean MWS was 93.3, with 3 complications (12%).
- Female gender correlated with smaller scaphoid width; screw distance was consistent across demographics.
Conclusions:
- The 2-screw construct demonstrates a favorable union rate and clinical outcomes for scaphoid fractures.
- The technique allows for consistent parallel screw placement irrespective of gender or body size.
- Gender influences scaphoid width but not screw placement consistency.
