Diagnosis and Management of Acute Scaphoid Fractures.

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Abstract

[Indexed for MEDLINE] 10. J Hand Surg Am. 2020 Aug;45(8):783.e1-783.e4. doi: 10.1016/j.jhsa.2020.03.013. Epub 2020 Apr 20. Two-Screw Fixation of Scaphoid Waist Fractures. Yildirim B(1), Deal DN(1), Chhabra AB(2). Author information: (1)Department of Orthopaedics, University of Virginia, Charlottesville, VA. (2)Department of Orthopaedics, University of Virginia, Charlottesville, VA. Electronic address: AC2H@hscmail.mcc.virginia.edu. Optimal fixation strategy for scaphoid waist fractures remains a contentious topic with options including using a single screw, 2 screws, or a scaphoid plate. Biomechanical studies favor 2-screw fixation with regards to higher load to failure, load to 2-mm displacement, energy absorbed, rotational stability, and stiffness. Furthermore, recent retrospective studies found increased union rate with 2 screws. Although conclusive clinical data are lacking, 2-screw fixation of a scaphoid waist fracture may theoretically allow the patient to start earlier range of motion and strengthening with greater confidence. Our experience with 2-screw fixation has been promising with all acute waist fractures healing and nonunions treated with 2 screws having high union and low reoperation rates. Copyright © 2020 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved. DOI: 10.1016/j.jhsa.2020.03.013