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Better arc of motion found with screw vs staple fixation of the wrist
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Logan McGinn, MD, performed a retrospective review of data for 64 patients who underwent either headless compression screw fixation (n=38) or staple fixation (n=26) for treatment of scaphoid lunate advanced collapse (SLAC) or scaphoid nonunion advanced collapse (SNAC).
“The primary functional outcomes included pre- vs. postoperative flexion extension, arc of motion and grip strength,” McGinn said in her presentation. “Secondary outcomes were complications and fusion rates.”
Results showed an overall postoperative decreased range of motion in both groups, with an average loss of 9.2° in the screw group and of 27.9° in the staple group. However, McGinn noted the loss of range of motion was only statistically significant in the screw group.
“Our data showed, on average, the screw group’s flexion extension range of motion had improved postoperatively by 8%, whereas the staple group consistently lost range as expected,” she said.
Patients who underwent staple fixation experienced immobilization on average 21 days longer vs. the screw fixation group, according to McGinn.
“All patients went on to union in the screw group compared to only 88.5% in the staple group,” McGinn said. “The time to union on average was 6 weeks longer in patients treated with staples.”
McGinn noted the staple group had a statistically significant higher complication rate at 50% vs. 13.2% in the screw group, which also led to a higher reoperation rate of 38.6% in the staple group compared with 7.9% in the screw group. – by Casey Tingle
Reference:
McGinn L. Paper #24. Presented at: American Society for Surgery of the Hand Annual Meeting; Sept. 7-9, 2017; San Francisco.
Disclosure: McGinn reports that she has no relevant financial disclosures.