Plaster fixationversus cannulated screw internal fixation for the wrist scaphoid bone fresh fracture：comparison of functional recovery

Kayishaer ? Maimaitiming; Zhao Yan

doi:10.3969/j.issn.2095-4344

Abstract：BACKGROUND:The stable fixation is not available due to specific position of wrist scaphoid fracture, the fracture is prone to non-union and ischemic necrosis of bone due to specific anatomy and blood supply. The choice between plaster fixation and internal fixation in treatment of wrist scaphoid bone fresh fracture remains controversial. <br> OBJECTIVE:To compare and analyze functional recovery of the wrist scaphoid bone fresh fracture after plaster fixation and internal fixation. <br> METHODS: Twenty-two patients with wrist scaphoid bone fresh fracture were recruited from the First Affiliated Hospital of Xinjiang Medical University from March 2012 to March 2014, and the injury time was 2 hours to 12 days. Preoperative X-ray films revealed that, the involved patients had no wrist scaphoid bone colapses, lunate bone dislocation, ischemic necrosis of bone and osseous changes. Al the cases showed shift, unstable fractures. According to the patient’s wiling and the surgical method, the involved patients were divided into two groups, receiving plaster fixation and cannulated screw internal fixation respectively. Each group contained 11 cases. Wrist joint function was evaluated using Cooney score system. There was no significant difference in the age distribution and gender between the two groups (P > 0.05). <br> RESULTS AND CONCLUSION: At 3-6 months of folow-up, wrist joint function of patients in the two groups was compared and analyzed with Cooney scores. According to the Cooney scores, nine cases in internal fixation group were excelent, 1 good, 1 fair and none poor; one case in plaster fixation group was excelent, 5 good, 3 fair, and 2 poor. The excelent and good rate in the internal fixation group was significantly higher than that in the plaster fixation group (91%, 55%,t=4.817,P < 0.05). Although plaster fixation has certain effects on wrist scaphoid bone fresh fracture, open reduction and canulated screw fixation has obvious effect and promotes the functional recovery of wrist joint. Compared with plaster fixation, open reduction and cannulated screw fixation has a superiority for treating wrist scaphoid bone fresh fracture.