A Comparison of Plate Versus Screw Fixation for Segmental Scaphoid Fractures: A Biomechanical Study

Goodwin, Jill; Castaneda, Paulo; Shelhamer, Ryan; Bosch, Liam; Edwards, Scott G.

doi:10.1177/1558944717732065

Cited by 13 publications

(4 citation statements)

References 29 publications

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“…Treatment of scaphoid nonunion with locking plates has been described previously. Biomechanical studies have reported that locking plate fixation has superior anti-rotational forces than fixation with a headless compression screw [ 8 ] and equal or better resistance to axial pressure loading [ 9 ]. Although there have been previous reports that plate fixation did not have superior mechanical characteristics to headless compression screws [ 10 ], plate fixation seems to be the most consistent biomechanical form of osteosynthesis with a high level of fragment stability and safe bone graft fixation maintaining the scaphoid length [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…We performed bone grafting from the distal radius because of a previous report that bone grafting from the distal radius and from the iliac bone had similar fusion rates in the treatment of scaphoid nonunion [ 11 ], and because the procedure could be performed under brachial plexus blocks. Furthermore, to perform firm fixation while maintaining the scaphoid length, fixation with a locking plate was performed [ 9 ]. In addition, the scaphoid was indirectly fixed and rested by temporarily fixing the midcarpal joint.…”

Section: Discussionmentioning

confidence: 99%

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Rare Case of Open Comminuted Scaphoid Fracture Dislocation: Treatment With Free Bone Graft and Locking Plate

Fukuda,

Miyashita,

Yasuda

2024

Cureus

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To the best of our knowledge, there are no reports in the literature of an open comminuted scaphoid fracture dislocation. We present such a rare case. The case report illustrates the case of a 58-year-old right-handed press operator who injured his left wrist when his hand got caught in a press machine. He received initial treatment at another hospital and was subsequently referred to our hospital. Eight days after the injury, surgery was performed under the brachial plexus block. Successful bone fusion was achieved through volar locking plate fixation, primary free bone grafting from the radius, and Kirschner wire fixation. Our case report may be a valuable resource for the treatment of similar injuries.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Rare Case of Open Comminuted Scaphoid Fracture Dislocation: Treatment With Free Bone Graft and Locking Plate

Fukuda,

Miyashita,

Yasuda

2024

Cureus

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“…The scaphoid plate is preferably used in the treatment of dislocation or comminuted fracture and nonunion [ 9 ]. A biomechanical study of plate versus screw in segmental scaphoid fracture showed that plate and screw fixation demonstrate similar loads to failure, but plate fixation was superior for gap recovery after an applied load to failure [ 13 ]. Another benefit of a plate is that it can prevent the extrusion of cortico-cancellous bone grafts in cases of nonunion.…”

Section: Discussionmentioning

confidence: 99%

Scaphoid Plate Osteosynthesis in Complex Fractures and Wrist Trauma: A Case Series

Liau,

Liew,

Arsad

et al. 2023

Cureus

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Introduction Treatment of scaphoid fracture is challenging due to its unique blood supply and geometry. Traditionally, a headless compression screw is the standard treatment for unstable scaphoid fracture. Some fractures are complex, for example, comminution with bone loss. A scaphoid plate is an option in these difficult fractures providing adequate rotational stability. Aim To share our experience in using scaphoid plates in complex wrist trauma and comminuted fractures. Method and material Complex wrist trauma involving scaphoid fractures that were comminuted and multi-fragmentary fractures treated with plate osteosynthesis were retrospectively reviewed between July 2019 and September 2021. Patient demographic data, preoperative radiographs, CT scans, pain, wrist range of motion, and fracture union rate to union were reviewed. Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH®) score was recorded at 1-year postoperative follow-up. Results Nine patients associated with complex wrist trauma were included in this case series. The mean follow-up was 2.5 years (13-30 months). The union rate was 100%. The mean arc of motion was 105° (95-110°). QuickDASH® score was 19.96 at 1-year postoperative follow-up. Four patients had good outcomes, four satisfactory, and one poor outcome. One hardware complication was observed which was the impingement of the plate proximally over the articular surface of the distal radius. Conclusion A scaphoid plate is a reliable option for treating complex and difficult fractures. It provides adequate stability, especially in comminution, bone loss, or multi-fragmentary fractures which are not amendable using other fixation methods. We recommend the expansion of plate osteosynthesis beyond scaphoid nonunion into complex wrist trauma.

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“…In the current case, after diagnosing the female with segmental scaphoid fracture, the treating team decided to use one 1 headless screw agist common surgical intervention with high success rate by returning to the normal movement range for the wrist with no pain. This was unlike to what reported by Goodwin JA., et al [13] who reported that "in scaphoid fractures with segmental defect, plate and screw fixation demonstrate similar loads to failure, but plate fixation performs superiorly to screw fixation for gap recovery after an applied load to failure". Also, Mandaleson A., et al [14] found that double screws or plate fixation demonstrated significantly greater stability, stiffness, and energy absorption when compared with a single compression screw.…”

Section: Discussionmentioning

confidence: 99%

Segmental Scaphoid Fracture treated with One Headless Screw: A Case Report

Asiri¹,

Alqahtan²,

Alraeh³

2023

Act Scie Ortho

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Background:The scaphoid is the most frequently fractured carpal bone, accounting for 71% of all carpal bone fractures. Scaphoid fractures often occur in young and middle-aged adults, typically those aged 15-60 years, after a fall on an outstretched arm that results in acute dorsal flexion of the wrist. Early diagnosis of a scaphoid fracture is important because nonunions is more likely if treatment is delayed.Aim: To report a case presented with Segmental scaphoid fracture treated with one headless Screw. Results:A 38 Saudi female present as case of left-hand swelling and pain for 1 day ago. The pain localized at volar of left hand at wrist which started after falling down. Clinical examination revealed inception with swelling close injury but no change in color. palpation revealed soft distal compartment tenderness distal with intact movement and limit rom. The patients undergone X-ray at ER and diagnosed to have Segmental scaphoid fracture. Started by conservative treatment with long arm spica. After 1 month, treating team decided for surgical intervention through dorsal approach to scaphoid and fixation by headless screw.

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A Comparison of Plate Versus Screw Fixation for Segmental Scaphoid Fractures: A Biomechanical Study

Abstract: In scaphoid fractures with segmental defect, plate and screw fixation demonstrate similar loads to failure, but plate fixation performs superiorly to screw fixation for gap recovery after an applied load to failure.

Cited by 13 publications

References 29 publications

Rare Case of Open Comminuted Scaphoid Fracture Dislocation: Treatment With Free Bone Graft and Locking Plate

Rare Case of Open Comminuted Scaphoid Fracture Dislocation: Treatment With Free Bone Graft and Locking Plate

Scaphoid Plate Osteosynthesis in Complex Fractures and Wrist Trauma: A Case Series

Segmental Scaphoid Fracture treated with One Headless Screw: A Case Report

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