Acute Scaphoid Waist Fracture in the Athlete

Non-Displaced Scaphoid Waist Fractures: Percutaneous Screw Fixation Versus Cast Immobilization

Background

Scaphoid waist fractures make up 66% of scaphoid fractures and are mostly non-displaced. The purpose of this study was to demonstrate that percutaneous screw fixation is preferable to cast immobilization in the treatment of non-displaced or minimally displaced scaphoid waist fractures.

Methodology

Between 2017 and 2019, we conducted a retrospective review of patients aged 17-65 years who underwent treatment for acute non-displaced scaphoid waist fractures. In total, 52 patients with scaphoid waist fractures were included in the analysis, 25 of whom underwent percutaneous screw treatment and 27 were treated with a short plaster cast. Patient satisfaction, pain, range of motion, and grip strength were evaluated using the Mayo Modified Wrist Score (MMWS). In addition, the time to return to work/sports, union time, complications, and non-union status were evaluated.

Results

A total of 52 (35 male, 15 female) patients were enrolled in this study. The average follow-up time was 24.9 months (range, 24-29 months). The mean age was 28.12 years (range, 17-45 months). Group 1 consisted of 25 patients who underwent percutaneous screw fixation, and group 2 consisted of 27 patients who were treated with a short plaster cast. There were significant differences in return to work, return to sports, and union time between the two groups (p < 0.001). The sixth-month MMWS was significantly different between the two groups (p < 0.001), but the first-year MMWS was not significantly different between the two groups (p = 0.864). There were no complications in both groups.

Conclusions

With percutaneous screw fixation, acute non-displaced or minimally displaced scaphoid waist fractures demonstrated a high rate of union and early return to work/sports.