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Percutaneous Screw Fixation of Scaphoid Nonunion Without Bone Grafting
Maria A Munsch1, Duc M Nguyen2, Samuel Crowley1
1University of Pittsburgh, PA, USA.
Hand (New York, N.Y.)
|April 21, 2026
Summary
Minimally invasive headless compression screw (HCS) fixation achieved a 71.4% union rate for scaphoid delayed unions and nonunions. Early surgical intervention within 4 months of injury is associated with better healing outcomes.
Area of Science:
- Orthopedic surgery
- Traumatology
- Skeletal repair
Background:
- Scaphoid delayed union and nonunion present treatment challenges.
- Minimally invasive techniques may preserve scaphoid blood supply.
- Headless compression screw (HCS) fixation is a potential treatment option.
Purpose of the Study:
- To evaluate the efficacy of minimally invasive HCS fixation for scaphoid delayed union/nonunion.
- To assess union rates and identify predictors of healing.
- To compare outcomes with traditional methods.
Main Methods:
- Retrospective review of 21 patients with scaphoid nonunion/delayed union.
- Treatment involved minimally invasive HCS fixation.
- Radiographic union assessed by a musculoskeletal radiologist; secondary outcomes included joint angles and complications.
Main Results:
- A 71.4% radiographic union rate was observed postoperatively.
- Fifteen patients achieved scaphoid healing; 4 had persistent nonunion.
- No significant correlation found between preoperative angles, age, and union rates.
Conclusions:
- Minimally invasive HCS fixation offers a viable treatment for scaphoid delayed unions and nonunions.
- Delayed surgery (>4 months) was linked to persistent nonunion.
- Percutaneous HCS fixation provides reasonable healing rates, irrespective of fracture location.
