Kirschner wire versus Herbert screw fixation for the treatment of unstable scaphoid waist fracture nonunion using corticocancellous iliac bone graft: randomized clinical trial.


Journal

International orthopaedics
ISSN: 1432-5195
Titre abrégé: Int Orthop
Pays: Germany
ID NLM: 7705431

Informations de publication

Date de publication:
11 2020
Historique:
received: 09 02 2020
accepted: 13 07 2020
pubmed: 20 7 2020
medline: 15 4 2021
entrez: 20 7 2020
Statut: ppublish

Résumé

The study compared the impact of the Kirschner wires versus Herbert screw fixation on the rate of union, time to union, correction of deformity, and clinical outcome in adults with unstable scaphoid waist fracture nonunions without avascular necrosis. We prospectively randomized 122 patients to undergo corticocancellous iliac bone grafting and internal fixation either with multiple Kirschner wires or Herbert screw. Radiographs, clinical outcome measures (pain, range of motion, and grip strength), and the Quick DASH score were taken pre- and post-operatively. The rate of the scaphoid union in the Kirschner wire group was 91% versus 88% in the Herbert group. No difference was detected between the two groups with respect to the time to union, deformity correction, pain analysis, range of motion, grip strength, return to work, and complications. Using of multiple Kirschner wires as a fixation method for unstable scaphoid waist fracture nonunion that was treated by open reduction and corticocancellous iliac bone grafting had a shorter operative time and lower cost as compared with the Herbert screw fixation. Herbert screw fixation was technically more demanding in terms of technique than K-wires. However, because of easy application of Kirschner wires, and low cost, especially in developing countries, it may be a good alternative to Herbert screw.

Identifiants

pubmed: 32683460
doi: 10.1007/s00264-020-04730-7
pii: 10.1007/s00264-020-04730-7
doi:

Types de publication

Journal Article Randomized Controlled Trial

Langues

eng

Sous-ensembles de citation

IM

Pagination

2385-2393

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Auteurs

Galal Hegazy (G)

Orthopedic Department, Faculty of Medicine, AL-Azhar University, Nasr City, Cairo, 11884, Egypt. glalhegazy@azhar.edu.eg.

Ehab Alshal (E)

Orthopedic Department, Faculty of Medicine, AL-Azhar University, Assiut, 71524, Egypt.

Mohamed Abdelaal (M)

Orthopedic Department, Faculty of Medicine, AL-Azhar University, Nasr City, Cairo, 11884, Egypt.

Mohamed Abdelaziz (M)

Orthopedic Department, Faculty of Medicine, AL-Azhar University, Nasr City, Cairo, 11884, Egypt.

Mohamed Moawad (M)

Orthopedic Department, Faculty of Medicine, AL-Azhar University, Nasr City, Cairo, 11884, Egypt.

Yasser M Saqr (YM)

Orthopedic Department, Faculty of Medicine, Port Said University, Port Said, 11884, Egypt.

Ibrahem El-Sebaey (I)

Orthopedic Department, Faculty of Medicine, AL-Azhar University, Nasr City, Cairo, 11884, Egypt.

Mokhtar Abdelazeem (M)

Orthopedic Department, Faculty of Medicine, AL-Azhar University, Nasr City, Cairo, 11884, Egypt.

Mohamed El-Barody (M)

Radiodiagnosis Department, South Egypt Cancer Institute, Assiut University, Assiut, 71524, Egypt.

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