Clinical outcomes of double-screw fixation with bone grafting for displaced scaphoid nonunions: A series of 21 cases

Abstract

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PurposeThis study reports the clinical outcomes of double-screw fixation with bone grafting for displaced scaphoid nonunions.Patients and methodsThis study was a retrospective survey. From January 2018 to December 2019, 21 patients with displaced scaphoid fractures underwent open debridement and two headless compression screw fixation with bone grafting. The preoperative and postoperative lateral intrascaphoid angle (LISA) and scapholunate angle (SLA) were recorded. Preoperative and postoperative grip strength (% of the healthy side), active range of motion (AROM), visual analogue scale (VAS), and patient-rated wrist evaluation (PRWE) scores at the final follow-up were obtained for all patients for comparison.ResultsPatients were treated for an average of 38.3 months (range 12–250) after the injury. The average time of postoperative follow-up was 30.5 months (range 24–48). All fractures achieved union at a mean of 2.7 months (range 2–4) after surgery, and 14 scaphoids of 21 patients (66.7%) healed by 8 weeks. CT scans showed no evidence of cortical penetration of either screw in all patients. There was a statistically significant improvement in AROM, grip strength, and PRWE. No complications occurred in this study, and all patients returned to work.ConclusionThis study indicates that double-screw fixation with bone grafting is an effective technique for treating displaced scaphoid nonunions.

Keywords

• displaced scaphoid nonunion
• double screws fixation
• bone grafting
• clinical outcome
• humpback deformity