Treatment of Unstable Scaphoid Fractures by Internal Fixation using Cannulated Screws: A retrospective study

Abstract

Background and Aim: Scaphoid bone fractures are common, as they represented 50%-75% of all carpal bone fractures in young active adults. However, no standard treatment protocol is widely accepted.  Unstable fractures represented an additional challenge. This study retrospectively evaluated the outcome of open reduction fixation of unstable scaphoid fractures using cannulated screws.   

Patients and Methods: Thirty-two patients’ files met the inclusion criteria and were included in final analysis. Data was collected from patients treated in Damietta General and Specialized hospitals between January and June 2022. All were treated by internal fixation with cannulated screws. Collected data included patient demographics, perioperative details and outcomes (clinical, radiological and functional).

Results:  Patient’s age ranged between 21 and 39 years (28.53±4.10 years), with male sex predominance (81.2%) and the right side was the commonly affected side (75.0%). Injuries were mainly due to falling on outstretched hands (56.3%). The follow up duration ranged between 15 to 18 weeks, (16.96±1.06 weeks). The complete union was achieved in 90.6%, with good functional outcome. The overall response (outcome) was graded as excellent (68.8%), good for 21.9% and poor for 9.4%. Excellent outcome was significantly associated with low fracture classification grade, higher postoperative range of motion (ROM), grip strength and activity scores.

Conclusion: Open reduction with fixation by cannulated screws seems to be a reasonable (safe with high success rate) option for treatment of unstable scaphoid fractures.