Percutaneous screw fixation for acute scaphoid fractures through K-wire-assisted reduction and maintenance:a randomized controlled trial

Abstract Background Most of the acute scaphoid fractures have been treated nonoperatively in a cast or by open surgery. Percutaneous screw fixation was introduced for acute scaphoid fractures through K-wire-assisted reduction and maintenance, and the effectiveness of the methods was evaluated. Methods From January 2015 to December 2018, a total of 20 patients were recruited to the study and 10 patients were randomly allocated to the open reduction and percutaneous groups respectively. Different groups received open reduction and internal fixation or percutaneous screw fixation. Function outcomes including the range of motion and grip strength were assessed according to the modified Mayo wrist scoring system. Results Final follow-up examination was performed on an average of 12 months after surgery. No immediate postoperative complication occurred. All patients achieved solid union as confirmed by CT scans. A significant increase in the functional recovery of the injured wrist in the percutaneous group than they were in the open reduction group. Conclusions Our novel percutaneous screw fixation method is beneficial to minimise injury to the blood supply of the scaphoid. Primary percutaneous screw fixation for acute scaphoid fractures is a superior method with reduced time to bony union, early return to daily activity or employment and predictably lessened complications of wrist stiffness, diminished grip strength, delayed union, non-union and osteonecrosis.