The Effect of Intra-carpal Kirschner Wire Augmentation in Screw Fixation of Scaphoid – A Retrospective Cohort Study
INTRODUCTION: Scaphoid fractures are most often treated with a single headless compression screw. However, intercarpal Kirschner wire (K-wire) might be added to improve stability and fracture outcomes. This study will determine if there is a difference in treatment outcome (union rate and time to un...
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| Format: | Article |
| Language: | English |
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Malaysian Orthopaedic Association
2020-11-01
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| Series: | Malaysian Orthopaedic Journal |
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| Online Access: | https://www.morthoj.org/2020/v14n3/intracarpal-kirschner-wire.pdf |
| _version_ | 1819135247214706688 |
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| author | Leow MQH Chung SR Tay SC |
| author_facet | Leow MQH Chung SR Tay SC |
| author_sort | Leow MQH |
| collection | DOAJ |
| description | INTRODUCTION: Scaphoid fractures are most often treated with a single headless compression screw. However, intercarpal Kirschner wire (K-wire) might be added to improve stability and fracture outcomes. This study will determine if there is a difference in treatment outcome (union rate and time to union) between scaphoid fracture fixations using a single headless compression screw with and without augmentation using a intracarpal intramedullary K-wire.
MATERIALS AND METHODS: We conducted a retrospective review of patients who underwent surgery for isolated scaphoid fractures over a 15 years period from December 2000 to December 2015. Only patients who underwent open surgery with bone grafting were included. They were divided into a group treated with a single screw fixation, and another group treated with screw and K-wire fixations.
RESULTS: Forty-four (58.7%) patients had single screw fixation and 31 (41.3%) had screw augmented with K-wire fixation. The overall union rate was 88.0%, with an overall mean time to union of 5.3 months. There was no difference in union rate (p=0.84) and time to union (p=0.66) between the single screw group and combined screw and K-wire group. Univariate analysis found that older age (t=-2.11,
p=0.04) had a significant effect on union rate. Regression model showed that age had a significant effect on months to union.
CONCLUSION: In open fixation of scaphoid fractures with compression screw and bone grafting, union rate and time to union is comparable whether or not screw fixation was augmented with an intracarpal K-wire. There was no increased risk of complications associated with augmented screw. Age of patient affected time to union and union rate. |
| first_indexed | 2024-12-22T10:16:03Z |
| format | Article |
| id | doaj.art-50928245004b4d2184c0722b4e587e83 |
| institution | Directory Open Access Journal |
| issn | 1985-2533 2232-111X |
| language | English |
| last_indexed | 2024-12-22T10:16:03Z |
| publishDate | 2020-11-01 |
| publisher | Malaysian Orthopaedic Association |
| record_format | Article |
| series | Malaysian Orthopaedic Journal |
| spelling | doaj.art-50928245004b4d2184c0722b4e587e832022-12-21T18:29:43ZengMalaysian Orthopaedic AssociationMalaysian Orthopaedic Journal1985-25332232-111X2020-11-0114310410910.5704/MOJ.2011.016The Effect of Intra-carpal Kirschner Wire Augmentation in Screw Fixation of Scaphoid – A Retrospective Cohort StudyLeow MQH0Chung SR1Tay SC2PhDMRCS (Edin)FRCSEINTRODUCTION: Scaphoid fractures are most often treated with a single headless compression screw. However, intercarpal Kirschner wire (K-wire) might be added to improve stability and fracture outcomes. This study will determine if there is a difference in treatment outcome (union rate and time to union) between scaphoid fracture fixations using a single headless compression screw with and without augmentation using a intracarpal intramedullary K-wire. MATERIALS AND METHODS: We conducted a retrospective review of patients who underwent surgery for isolated scaphoid fractures over a 15 years period from December 2000 to December 2015. Only patients who underwent open surgery with bone grafting were included. They were divided into a group treated with a single screw fixation, and another group treated with screw and K-wire fixations. RESULTS: Forty-four (58.7%) patients had single screw fixation and 31 (41.3%) had screw augmented with K-wire fixation. The overall union rate was 88.0%, with an overall mean time to union of 5.3 months. There was no difference in union rate (p=0.84) and time to union (p=0.66) between the single screw group and combined screw and K-wire group. Univariate analysis found that older age (t=-2.11, p=0.04) had a significant effect on union rate. Regression model showed that age had a significant effect on months to union. CONCLUSION: In open fixation of scaphoid fractures with compression screw and bone grafting, union rate and time to union is comparable whether or not screw fixation was augmented with an intracarpal K-wire. There was no increased risk of complications associated with augmented screw. Age of patient affected time to union and union rate.https://www.morthoj.org/2020/v14n3/intracarpal-kirschner-wire.pdfscaphoid fracture non-unionintracarpal kirschner wireintramedullary screwaugmented fixation |
| spellingShingle | Leow MQH Chung SR Tay SC The Effect of Intra-carpal Kirschner Wire Augmentation in Screw Fixation of Scaphoid – A Retrospective Cohort Study Malaysian Orthopaedic Journal scaphoid fracture non-union intracarpal kirschner wire intramedullary screw augmented fixation |
| title | The Effect of Intra-carpal Kirschner Wire Augmentation in Screw Fixation of Scaphoid – A Retrospective Cohort Study |
| title_full | The Effect of Intra-carpal Kirschner Wire Augmentation in Screw Fixation of Scaphoid – A Retrospective Cohort Study |
| title_fullStr | The Effect of Intra-carpal Kirschner Wire Augmentation in Screw Fixation of Scaphoid – A Retrospective Cohort Study |
| title_full_unstemmed | The Effect of Intra-carpal Kirschner Wire Augmentation in Screw Fixation of Scaphoid – A Retrospective Cohort Study |
| title_short | The Effect of Intra-carpal Kirschner Wire Augmentation in Screw Fixation of Scaphoid – A Retrospective Cohort Study |
| title_sort | effect of intra carpal kirschner wire augmentation in screw fixation of scaphoid a retrospective cohort study |
| topic | scaphoid fracture non-union intracarpal kirschner wire intramedullary screw augmented fixation |
| url | https://www.morthoj.org/2020/v14n3/intracarpal-kirschner-wire.pdf |
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