scholarly journals The Headless Compression Screw – Technical challenges in scaphoid fracture fixation

2015 ◽  
Vol 12 ◽  
pp. S211-S216 ◽  
Author(s):  
Usman Ahmed ◽  
Shahbaz Malik ◽  
Michael David ◽  
Claire Simpson ◽  
Simon Tan ◽  
...  
Keyword(s):  
Fracture Fixation ◽  
Scaphoid Fracture ◽  
Compression Screw ◽  
Headless Compression Screw ◽  
Technical Challenges

Early results of a new implant: 3.0 mm headless compression screw for scaphoid fracture fixation

2012 ◽  
Vol 37 (7) ◽  
pp. 690-693 ◽  
Author(s):  
K. Singisetti ◽  
E. Aldlyami ◽  
A. Middleton
Keyword(s):  
Internal Fixation ◽  
Fracture Fixation ◽  
Scaphoid Fracture ◽  
Compression Screw ◽  
Headless Compression Screw ◽  
Scaphoid Fractures ◽  
Early Results ◽  
Fracture Nonunions ◽  
Radiological Healing ◽  
Vascularized Bone

There has been a considerable evolution of screws used for internal fixation of scaphoid fractures. We discuss here, early results of a recently introduced implant Synthes 3.0 mm headless compression screw used for scaphoid fracture fixation. Twenty eight patients with scaphoid fractures (five acute and 23 nonunions) were treated with internal fixation by this non-variable pitch screw over a period of 18 months. All nonunions had pedicle vascularized bone grafting. All five patients with acute scaphoid fracture fixation had radiological healing at a mean of 8 weeks. Fifteen of 23 scaphoid fracture nonunions showed definite signs and a further seven showed probable signs of radiological healing at a mean of 8 months. One nonunion has failed to unite after surgery.

scholarly journals Impact of Screw Length on Proximal Scaphoid Fracture Biomechanics

2019 ◽  
Vol 08 (05) ◽  
pp. 360-365 ◽  
Author(s):  
Samik Patel ◽  
Juan Giugale ◽  
Nathan Tiedeken ◽  
Richard E. Debski ◽  
John R. Fowler
Keyword(s):  
Cyclic Loading ◽  
Fracture Fixation ◽  
Ultimate Load ◽  
Scaphoid Fracture ◽  
Fracture Site ◽  
Compression Screw ◽  
Headless Compression Screw ◽  
Scaphoid Fractures ◽  
Screw Length ◽  
Significant Difference

Background Proximal scaphoid fractures display high nonunion rates and increased revision cases. Waist fracture fixation involves maximizing screw length within the cortex; however, the optimal screw length for proximal scaphoid fractures remains unknown. Purpose The main purpose of this article is to compare stiffness and ultimate load for proximal scaphoid fracture fixation of various headless compression screw lengths. Methods Eighteen scaphoids underwent an osteotomy simulating a 7 mm oblique proximal fracture. Screws of three lengths (10, 18, and 24 mm) were randomly assigned for fixation. Each specimen underwent cyclic loading with stiffness calculated during the last loading cycle. Specimens that withstood cyclic loading were loaded to failure. Results No significant difference in stiffness between screw lengths was found. Ultimate load was significantly impacted by the screw length. A significant difference in ultimate load between a 10 and 24 mm screw was found; however, no significant difference occurred in ultimate load between an 18 and 24 mm screw. Conclusions No significant difference in stiffness between all groups could be due to similarities in purchase in the proximal aspect. The 10 mm screw withstanding less ultimate load compared to the 24 mm screw could be due to the 10 mm screw gaining less purchase on either side of the fracture site compared to the 24 mm screw. Lack of significant difference in ultimate load between the 18 and 24 mm screw could be occurring because the fracture site is closer to the 18 mm screw midpoint, as distal threads are engaged closer to the fracture. Clinical Relevance Maximizing screw length may not provide superior fixation biomechanically compared with fixation utilizing a 6 mm shorter screw for proximal scaphoid fractures.

scholarly journals Metacarpal Bony Dimensions Related to Headless Compression Screw Sizes

2019 ◽  
Vol 12 (S 01) ◽  
pp. S39-S44
Author(s):  
Michael Okoli ◽  
Kevin Lutsky ◽  
Michael Rivlin ◽  
Brian Katt ◽  
Pedro Beredjiklian
Keyword(s):  
Computed Tomography ◽  
Fracture Fixation ◽  
Ct Scans ◽  
Compression Screw ◽  
Metacarpal Head ◽  
Headless Compression Screw ◽  
Metacarpal Bones ◽  
Headless Compression Screws ◽  
The Mean ◽  
Distal Aspect

Abstract Introduction The purpose of this study is to determine the radiographic dimensions of the finger metacarpals and to compare these measurements with headless compression screws commonly used for fracture fixation. Materials and Methods We analyzed computed tomography (CT) scans of the index, long, ring, and small metacarpal bones and measured the metacarpal length, distance from the isthmus to the metacarpal head, and intramedullary diameter of the isthmus. Metacarpals with previous fractures or hardware were excluded. We compared these dimensions with the size of several commercially available headless screws used for intramedullary fixation. Results A total of 223 metacarpals from 57 patients were analyzed. The index metacarpal was the longest, averaging 67.6 mm in length. The mean distance from the most distal aspect of the metacarpal head to the isthmus was 40.3, 39.5, 34.4, and 31 mm for the index, long, ring, and small metacarpals, respectively. The narrowest diameter of the isthmus was a mean of 2.6, 2.7, 2.3, and 3 mm for the index, long, ring, and small metacarpals, respectively. Of 33 commercially available screws, only 27% percent reached the isthmus of the index metacarpal followed by 42, 48, and 58% in the long, ring, and small metacarpals, respectively. Conclusion The index and long metacarpals are at a particular risk of screw mismatch given their relatively long lengths and narrow isthmus diameters.

SIMULTANEOUS FRACTURE OF THE WAIST OF THE SCAPHOID AND THE HOOK OF THE HAMATE

Hand Surgery ◽  
2010 ◽  
Vol 15 (03) ◽  
pp. 233-234 ◽  
Author(s):  
Shingo Komura ◽  
Yasushi Suzuki ◽  
Tatsuya Ikehata
Keyword(s):  
Scaphoid Fracture ◽  
The Body ◽  
Bone Union ◽  
Compression Screw ◽  
First Report ◽  
Cast Immobilisation ◽  
Headless Compression Screw

A case of simultaneous fracture of the waist of the scaphoid and the hook of the hamate is presented. The scaphoid fracture was treated surgically with a headless compression screw, while the hook fracture was treated conservatively with cast immobilisation for eight weeks. Both fractures achieved bone union and the patient returned to work without any symptoms or complications. Only two cases of fractures of the scaphoid and hamate have been reported previously. However, both of them involved fracture of the body of the hamate. This is the first report of simultaneous fracture of the scaphoid and the hook of the hamate.

scholarly journals A Unique Presentation of Scaphocapitate Syndrome With Extrusion Into the Carpal Tunnel: A Case Report

Hand ◽  
2018 ◽  
Vol 13 (6) ◽  
pp. NP39-NP45
Author(s):  
Sheriff D. Akinleye ◽  
Eitan Melamed
Keyword(s):  
Carpal Tunnel ◽  
Scaphoid Fracture ◽  
Dorsal Approach ◽  
Compression Screw ◽  
Unique Case ◽  
Unique Challenge ◽  
Volar Approach ◽  
Headless Compression Screw ◽  
Headless Compression Screws ◽  
Capitate Fracture

Background: Scaphocapitate syndrome is a rare variety of perilunate instability, described as a trans-scaphoid, trans-capitate fracture, with rotation of the capitate head either 90° or 180°. Methods: We present a unique case of scaphocapitate syndrome in which the rotated proximal capitate fragment expelled into the carpal canal. Results: The capitate head was extricated from the carpal tunnel via the volar approach, and was anatomically aligned and fixed through the dorsal approach using two 2.0 mm headless compression screws. The scaphoid fracture was then also reduced through the dorsal approach and stabilized with a 2.5 mm headless compression screw. All intercarpal ligaments appeared intact. Conclusions: Volar dislocation of the proximal capitate into the carpal tunnel in scaphocapitate syndrome presents a unique challenge that can be addressed with a combined volar and dorsal approach.

Trans-metacarpal Screw Fixation for Extra-articular Proximal Phalangeal Base Fractures

2017 ◽  
Vol 22 (01) ◽  
pp. 35-38 ◽  
Author(s):  
Eichi Itadera ◽  
Takahiro Yamazaki
Keyword(s):  
Screw Fixation ◽  
Proximal Phalanx ◽  
Metacarpophalangeal Joint ◽  
Fixation Method ◽  
Compression Screw ◽  
Metacarpal Head ◽  
Headless Compression Screw ◽  
Articular Fractures ◽  
Intramedullary Canal ◽  
Cannulated Drill

We developed a new internal fixation method for extra-articular fractures at the base of the proximal phalanx using a headless compression screw to achieve rigid fracture fixation through a relatively easy technique. With the metacarpophalangeal joint of the involved finger flexed, a smooth guide-pin is inserted into the intramedullary canal of the proximal phalanx through the metacarpal head and metacarpophalangeal joint. Insertion tunnels are made over the guide-pin using a cannulated drill. Then, a headless cannulated screw is placed into the proximal phalanx. All of five fractures treated by this procedure obtained satisfactory results.

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