Percutaneous Headless Cannulated Screw versus Pinning in Fixation of Scaphoid Waist Fracture: Comparative Study

Document Type : Original Article

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Department of Orthopedic Surgery, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt.

10.21608/aimj.2025.400063.2605

Abstract

Background: Scaphoid waist fractures are common among young adults, often necessitating surgical fixation for optimal recovery.
Aim: This study compares percutaneous headless cannulated screw fixation (Herbert screw) versus Kirschner wire (K-wire) pinning in terms of radiological union and functional outcomes.
Methods: This prospective study included 30 patients (15 per group) with recent, non-displaced scaphoid waist fractures treated at Al Azhar University Hospitals. Group I received closed reduction and Herbert screw fixation; Group II received closed reduction and percutaneous pinning with K-wires. Cases have been followed for six months with clinical assessments (Mayo Modified Wrist Score, grip strength, pain score) and radiological evaluations to monitor union and complications.
Results: Both groups were similar in age, BMI, injury mechanism, and surgical time. Screw fixation resulted in significantly faster radiological union (mean 4.07 vs. 4.73 weeks, p=0.009) and earlier return to work/sports (mean 3.4 vs. 7.2 weeks, p<0.001). The screw group demonstrated significantly better grip strength (p=0.003), less pain (VAS, p=0.001), and higher functional scores (p=0.04). Insignificant variances have been found in range of motion or complication rates, though infections were seen only in the K-wire group.
Conclusion: Percutaneous headless screw fixation offers superior functional recovery, faster union, and earlier return to activity compared to K-wire pinning, making it a preferable option for treating non-displaced scaphoid waist fractures in active adults.

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