Skip to main content
SpringerLink
Log in

Implantology of Fractures of the Carpal Bones

  • Reference work entry
  • First Online:
Handbook of Orthopaedic Trauma Implantology

  • 21 Accesses

Abstract

Fractures of the carpal bones are challenging conditions to treat because the bones are intrasynovial, mostly covered with cartilage and have tenuous blood supplies. These factors pose a higher risk of complications such as delayed union, non-union, avascular necrosis, and post-traumatic arthritis. The small size and complex 3D geometry of these bones demand very precise placement of internal fixation implants and there is very little room for error. There have been rapid advances in the development of implants for scaphoid and other carpal fractures in the past four decades. This chapter will discuss the concepts behind their design and evolution, the biomechanical properties, clinical results as well as complications. The chapter will conclude with technical tips for internal fixation of scaphoid fractures using the headless compression screw so that the surgeon can consistently achieve good results.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 1,599.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 1,599.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Merrell GA, Wolfe SW, Slade JF 3rd. Treatment of scaphoid nonunions: quantitative meta-analysis of the literature. J Hand Surg Am. 2002;27(4):685–91.

    Article  PubMed  Google Scholar 

  2. Rancy SK, Schmidle G, Wolfe SW. Does anyone need a vascularized graft? Hand Clin. 2019;35(3):323–44.

    Article  PubMed  Google Scholar 

  3. Russe O. Fracture of the carpal navicular. Diagnosis, non-operative treatment, and operative treatment. J Bone Joint Surg Am. 1960;42-A:759–68.

    Article  CAS  PubMed  Google Scholar 

  4. Herbert TJ, Fisher WE. Management of the fractured scaphoid using a new bone screw. J Bone Joint Surg Br. 1984;66(1):114–23.

    Article  CAS  PubMed  Google Scholar 

  5. Wu J, Tay SC, Shin AY. The effect of screw design on union rates in scaphoid nonunions. Hand Surg. 2015;20(2):273–9.

    Article  PubMed  Google Scholar 

  6. Whipple TL. The role of arthroscopy in the treatment of intra-articular wrist fractures. Hand Clin. 1995;11(1):13–8.

    Article  CAS  PubMed  Google Scholar 

  7. Toby EB, Butler TE, McCormack TJ, Jayaraman G. A comparison of fixation screws for the scaphoid during application of cyclical bending loads. J Bone Joint Surg Am. 1997;79(8):1190–7.

    Article  CAS  PubMed  Google Scholar 

  8. Faran KJ, Ichioka N, Trzeciak MA, Han S, Medige J, Moy OJ. Effect of bone quality on the forces generated by compression screws. J Biomech. 1999;32(8):861–4.

    Article  CAS  PubMed  Google Scholar 

  9. Beadel GP, Ferreira L, Johnson JA, King GJ. Interfragmentary compression across a simulated scaphoid fracture--analysis of 3 screws. J Hand Surg Am. 2004;29(2):273–8.

    Article  PubMed  Google Scholar 

  10. Assari S, Darvish K, Ilyas AM. Biomechanical analysis of second-generation headless compression screws. Injury. 2012;43(7):1159–65.

    Article  PubMed  Google Scholar 

  11. Bailey CA, Kuiper JH, Kelly CP. Biomechanical evaluation of a new composite bioresorbable screw. J Hand Surg Br. 2006;31(2):208–12.

    Article  CAS  PubMed  Google Scholar 

  12. Ya’ish F, Bailey CA, Kelly CP, Craigen MA. Bioabsorbable fixation of scaphoid fractures and non-unions; analysis of early clinical outcomes. Hand Surg. 2013;18(3):343–9.

    Article  PubMed  Google Scholar 

  13. Hart A, Harvey EJ, Lefebvre LP, Barthelat F, Rabiei R, Martineau PA. Insertion profiles of 4 headless compression screws. J Hand Surg Am. 2013;38(9):1728–34.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Crawford LA, Powell ES, Trail IA. The fixation strength of scaphoid bone screws: an in vitro investigation using polyurethane foam. J Hand Surg Am. 2012;37(2):255–60.

    Article  PubMed  Google Scholar 

  15. Oduwole KO, Cichy B, Dillon JP, Wilson J, O’Beirne J. Acutrak versus Herbert screw fixation for scaphoid non-union and delayed union. J Orthop Surg (Hong Kong). 2012;20(1):61–5.

    Article  PubMed  Google Scholar 

  16. Gregory JJ, Mohil RS, Ng AB, Warner JG, Hodgson SP. Comparison of Herbert and Acutrak screws in the treatment of scaphoid non-union and delayed union. Acta Orthop Belg. 2008;74(6):761–5.

    PubMed  Google Scholar 

  17. Shapiro JS. Power staple fixation in hand and wrist surgery: new applications of an old fixation device. J Hand Surg Am. 1987;12(2):218–27.

    Article  CAS  PubMed  Google Scholar 

  18. Korkala OL, Antti-Poika IU. Late treatment of scaphoid fractures by bone grafting and compression staple osteosynthesis. J Hand Surg Am. 1989;14(3):491–5.

    Article  CAS  PubMed  Google Scholar 

  19. Dunn J, Kusnezov N, Fares A, Mitchell J, Pirela-Cruz M. The scaphoid staple: a systematic review. Hand (N Y). 2017;12(3):236–41.

    Article  PubMed  Google Scholar 

  20. Ender HG. A new method of treating traumatic cysts and pseudoarthrosis of the scaphoid (author’s transl). Unfallheilkunde. 1977;80(12):509–13.

    CAS  PubMed  Google Scholar 

  21. Huene DR, Huene DS. Treatment of nonunions of the scaphoid with the ender compression blade plate system. J Hand Surg Am. 1991;16(5):913–22.

    Article  CAS  PubMed  Google Scholar 

  22. Braun C, Gross G, Buhren V. Osteosynthesis using a buttress plate--a new principle for stabilizing scaphoid pseudarthroses. Unfallchirurg. 1993;96(1):9–11.

    CAS  PubMed  Google Scholar 

  23. Ghoneim A. The unstable nonunited scaphoid waist fracture: results of treatment by open reduction, anterior wedge grafting, and internal fixation by volar buttress plate. J Hand Surg Am. 2011;36(1):17–24.

    Article  PubMed  Google Scholar 

  24. Wu F, Ng CY, Hayton M. The authors’ technique for volar plating of scaphoid nonunion. Hand Clin. 2019;35(3):281–6.

    Article  PubMed  Google Scholar 

  25. Mirrer J, Yeung J, Sapienza A. Anatomic locking plate fixation for scaphoid nonunion. Case Rep Orthop. 2016;2016:7374101.

    PubMed  PubMed Central  Google Scholar 

  26. Bain GI, Turow A, Phadnis J. Dorsal plating of unstable scaphoid fractures and nonunions. Tech Hand Up Extrem Surg. 2015;19(3):95–100.

    Article  PubMed  Google Scholar 

  27. Leixnering M, Pezzei C, Weninger P, et al. First experiences with a new adjustable plate for osteosynthesis of scaphoid nonunions. J Trauma. 2011;71(4):933–8.

    CAS  PubMed  Google Scholar 

  28. Dodds SD, Williams JB, Seiter M, Chen C. Lessons learned from volar plate fixation of scaphoid fracture nonunions. J Hand Surg Eur Vol. 2018;43(1):57–65.

    Article  PubMed  Google Scholar 

  29. Buijze GA, Doornberg JN, Ham JS, Ring D, Bhandari M, Poolman RW. Surgical compared with conservative treatment for acute nondisplaced or minimally displaced scaphoid fractures: a systematic review and meta-analysis of randomized controlled trials. J Bone Joint Surg Am. 2010;92(6):1534–44.

    Article  PubMed  Google Scholar 

  30. McQueen MM, Gelbke MK, Wakefield A, Will EM, Gaebler C. Percutaneous screw fixation versus conservative treatment for fractures of the waist of the scaphoid: a prospective randomised study. J Bone Joint Surg Br. 2008;90(1):66–71.

    Article  CAS  PubMed  Google Scholar 

  31. Lee SK, Byun DJ, Roman-Deynes JL, Model Z, Wolfe SW. Hybrid Russe procedure for scaphoid waist fracture nonunion with deformity. J Hand Surg Am. 2015;40(11):2198–205.

    Article  PubMed  Google Scholar 

  32. Waters MJ, Ruchelsman DE, Belsky MR, Leibman MI. Headless bone screw fixation for combined volar lunate facet distal radius fracture and capitate fracture: case report. J Hand Surg Am. 2014;39(8):1489–93.

    Article  PubMed  Google Scholar 

  33. Ball B, Bergman JW. Scaphoid excision and 4-corner fusion using retrograde headless compression screws. Tech Hand Up Extrem Surg. 2012;16(4):204–9.

    Article  PubMed  Google Scholar 

  34. Greenberg A, Shreve M, Bazylewicz D, Goldstein R, Sapienza A. Early motion following 4-corner arthrodesis using cannulated compression screws: a biomechanical study. J Hand Surg Am. 2013;38(11):2180–7.

    Article  PubMed  Google Scholar 

  35. Linnell JD, Bernstein DT, Sanderson CJ, Netscher DT, Mitchell SA. A cadaver investigation of screw purchase with 2 retrograde techniques for capitolunate arthrodesis. J Hand Surg Am. 2016;41(3):362–6.

    Article  PubMed  Google Scholar 

  36. Ingoe HMA, O’Hare JF, Middleton A. A functional angle of up to 35 degrees at the distal interphalangeal joint can be achieved with headless compression screw fusion. J Hand Surg Asian Pac Vol. 2018;23(3):377–81.

    Article  PubMed  Google Scholar 

  37. Shifflett GD, Athanasian EA, Lee SK, Weiland AJ, Wolfe SW. Proximal migration of hardware in patients undergoing midcarpal fusion with headless compression screws. J Wrist Surg. 2014;3(4):250–61.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Hand & Reconstructive Microsurgery, National University Health System, Singapore, Singapore

    Soumen Das De

Authors
  1. Soumen Das De
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Soumen Das De .

Editor information

Editors and Affiliations

  1. NH Narayana Superspeciality and Multispeciality Hospitals, Howrah, West Bengal, India

    Arindam Banerjee

  2. Technical University of Munich, Munich, Germany

    Peter Biberthaler

  3. Sri Lakshmi Narayana Institute of Medical Sciences, Puducherry, India

    Saseendar Shanmugasundaram

Section Editor information

  1. Dept. of Orthopaedics, Apollo Gleneagles Hospitals, Kolkata, West Bengal, India

    Ravi G. Bharadwaj

  2. Sri Dhaatri Orthopaedic, Maternity & Gynaecology Center, Vijayawada, India

    Srinivas B. S. Kambhampati

Rights and permissions

Reprints and permissions

Copyright information

© 2023 Springer Nature Singapore Pte Ltd.

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Das De, S. (2023). Implantology of Fractures of the Carpal Bones. In: Banerjee, A., Biberthaler, P., Shanmugasundaram, S. (eds) Handbook of Orthopaedic Trauma Implantology. Springer, Singapore. https://doi.org/10.1007/978-981-19-7540-0_74

Download citation

  • DOI: https://doi.org/10.1007/978-981-19-7540-0_74

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-19-7539-4

  • Online ISBN: 978-981-19-7540-0

  • eBook Packages: MedicineReference Module Medicine

Publish with us

Policies and ethics

Search

Navigation