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14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Percutaneous stabilization of scaphoid fractures with headless compression screw fixation

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  • presenting/speaker Sabrina Holzer - General Hospital of Vienna, Department of Orthopedic and Trauma Surgery, Division of Trauma Surgery, Vienna, Austria
  • Gabriel Halát - General Hospital of Vienna, Department of Orthopedic and Trauma Surgery, Division of Trauma Surgery, Vienna, Austria
  • Bernhard J. Maier - General Hospital of Vienna, Department of Orthopedic and Trauma Surgery, Division of Trauma Surgery, Vienna, Austria
  • Gerhild Thalhammer - General Hospital of Vienna, Department of Orthopedic and Trauma Surgery, Division of Trauma Surgery, Vienna, Austria
  • Irena Krusche-Mandl - General Hospital of Vienna, Department of Orthopedic and Trauma Surgery, Division of Trauma Surgery, Vienna, Austria

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-232

doi: 10.3205/19ifssh0505, urn:nbn:de:0183-19ifssh05058

Published: February 6, 2020

© 2020 Holzer et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives/Interrogation: Scaphoid fractures, being the most common carpal fractures, are associated with functional deficiencies of the wrist in a generally young population. In the treatment of those fractures, percutaneous scaphoid stabilization with headless compression screw fixation is a well-established procedure allowing early mobilization, shortened time away from work combined with high consolidation rates.

Our aim was to evaluate our clinical, radiological and functional results of percutaneously stabilized scaphoids.

Methods: We applied a set of in- and exclusion criteria, such as a minimal age of 15, no relevant other wrist lesions, no perilunar luxation mechanism (B4 fractures) and a minimal follow-up time of one year. Out of 107 consecutively treated scaphoid fractures with a headless compression screw (Acutrak ™) in the years 2000-2017, a total of 81 patients was incorporated in the study.

Following parameters were analyzed: time of consolidation, immobilization time, return time to work, pinch and grip strength, radiological classification, Disability of the Arm and Shoulder Score (DASH) and the Patient Related Wrist Evaluation (PRWE).

Results and Conclusions: A mean age of 26 years (range: 15-79) was observed in a predominantly male (84%) population. Mean follow-up time was 4.5 years (range 1-17). With 63.8% the B2 fracture was the most commonly observed fracture. We achieved a consolidation rate of 98.8% with only one case of scaphoid nonunion. Three additional cases of delayed union were observed, yet all of those cases achieved full consolidation within 4-7 months after surgery. Mean consolidation time was 12 weeks with an average DASH of 0.98 and a PRWE of 0.2.

The treatment of scaphoid fractures with percutaneous headless compression screw fixation is a convenient treatment option, allowing satisfying consolidation rates with good functional outcome.