Functional outcome in surgical management of scaphoid fractures with k wire and headless compression screw

Abstract

Background: Achieving stable fixation of scaphoid fractures and nonunions continues to be a challenge. Compression screw fixation has been the current standard surgical procedure. Materials and Methods: A retrospective study was conducted of 8 patients having closed scaphoid fractures at our institution over a 3 year period. Out of these, 4 patients were operated with percutaneous k wire fixation and 4 patients with open reduction and fixation with Herbert’s screw. A review of clinical as well as radiographic data was undertaken. The mechanism of injury, patient demographics, timing of surgery, initial displacement, fixation method, smoking status, and lunate morphology were recorded. Functional outcome measures were recorded. Results: A total of 7 out of 8 patients (87 %) showed evidence of union at 12 weeks post-injury. Similarly, fractures sustained via low energy mechanisms had a higher rate of early union compared to high energy mechanisms. Conclusions: Initial displacement and mechanism of injury have the most significant effects on early rates of union. early fixation of these fractures is recommended to prevent further displacement. One may prefer surgery because of an earlier return to work and mobility.