Enhanced scaphoid fixation with Kirschner wire: A clinical and finite element study

Area of Science:

• Orthopedic surgery
• Trauma surgery
• Biomedical engineering

Background:

• Scaphoid fractures and nonunions present challenges in achieving optimal healing and functional recovery.
• Current fixation methods, primarily headless compression screws, aim to provide stability but may have limitations.

Purpose of the Study:

• To evaluate the impact of augmenting headless compression screw fixation with a Kirschner wire (K-wire) on biomechanical and clinical outcomes in scaphoid fracture and nonunion treatment.

Main Methods:

• Retrospective analysis of 23 patients with scaphoid fractures/nonunions, divided into screw-only and screw + K-wire groups.
• Clinical outcomes assessed using VAS, Mayo Wrist Score, and QuickDASH.
• Biomechanical performance evaluated via finite element analysis.

Main Results:

• The screw + K-wire group showed significantly better functional scores (Mayo Wrist Score, QuickDASH) and lower pain (VAS) post-surgery.
• Finite element analysis indicated reduced stress concentration at the fracture site with the addition of a K-wire.

Conclusions:

• Augmenting headless compression screw fixation with a K-wire appears to enhance biomechanical stability and improve clinical results for scaphoid fractures.
• K-wire addition may be a valuable strategy for promoting fracture healing and alleviating postoperative pain.