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. 2021 Apr 20:18:56-60.
doi: 10.1016/j.jcot.2021.03.022. eCollection 2021 Jul.

How to ease the fixation of carpal bones? Twenty-four lesions treated by 1,5 mm headless compression screws

Andrea Poggetti  1 , Chiara Suardi  1 , Giulio Lauri  1 , David Espen  2 , Prospero Bigazzi  1 , Sandra Pfanner  2
Affiliations

How to ease the fixation of carpal bones? Twenty-four lesions treated by 1,5 mm headless compression screws

Andrea Poggetti et al. J Clin Orthop Trauma. .

Abstract

Background: Carpal bone lesions are common, even in acute injuries or as sequalae of missed fractures. If not correctly diagnosed and treated, can lead to loss of function, especially in active patients. The surgical management remain difficult particularly in case of small, atypical or non-unions fragments. The treatment of heterogenic shape fractures should require a fragment specific fixation using, traditionally, Kirschner-wire (K-wire). This method of treatment remains the most popular but could be prone to some complication as: not stable fixation, need to long time immobilization and wire mobilization. Methods Nineteen patients presented with carpal bone lesions were treated by the use of HCS 1,5 mm headless compression screws. Patients were evaluated post-operative by Patient-Rated Wrist Evaluation (PRWE), the Visual Analogic Scale (VAS), Quick-DASH Score and the grip strength was measured by Jamar dynamometer.

Results: Authors observed improvement of pain control and common activity; fine movements were restored; we observed no post-operative functional instability.

Conclusions: HCS 1,5 mm headless compression screws are suitable and smart technique to treat these uncommon fractures to achieve a stable primary fixation and allow an early mobilization and conciliate the versatility of K-wire and the compression action due to screws also in small bone fragment.

Keywords: Carpal bones; Carpal fractures; HCS; Kirschner-wire, K-wire; Patient-Rated Wrist Evaluation, PRWE; Scaphoid; Screw; the Visual Analogic Scale, VAS.

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Conflict of interest statement

The authors declare that they have no conflict of interests.

Figures

Fig. 5
Fig. 5
AP view: two 1.5 mm headless compression screws used to reduce and fix a scaphoid fracture.
Fig. 1
Fig. 1
Distal radius fracture with scaphoid and triquetrum involvement.
Fig. 2
Fig. 2
Carpo-metacarpal joint dislocation with small bone key fragments.
Fig. 3
Fig. 3
AP view: 1.5 mm headless compression screws, fixing the key fragments.
Fig. 4
Fig. 4
LL view: 1.5 mm headless compression screws, fixing the key fragments.
Fig. 6
Fig. 6
LL view: two 1.5 mm headless compression screws used to reduce and fix a scaphoid fracture.
Fig. 7
Fig. 7
Clinical result after scaphoid fixation.
Fig. 8
Fig. 8
Clinical result after scaphoid fixation.
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