Comparative Study between Volar Open and Percutaneous Surgical Fixation of Recent Scaphoid Fractures

Background: Since the scaphoid is the most often broken carpal bone, making up to 11% of all hand fractures and 60% of carpal bone fractures, it is regarded as a common injury. Objective: This study compared the results of open reduction and internal fixation without bone grafting through volar approach versus volar percutaneous fixation by Herbert screw of recent scaphoid waist fractures within 3 weeks. Patients and Methods: This prospective study included 34 patients with recent middle third scaphoid fracture in the Orthopedic Department of Menoufia University Hospital from 2019 to 2021. Patients were divided into two equal groups according to the treatment method (group A by open reduction, and group B by percutaneous fixation) using the volar approach. Result: The mean postoperative final score according to MMWS for group A was 69.71±15.26 but for group B it was 77.35±10.33. The mean postoperative pain score for group A was 16.76±4.98 and for group B it was 18.24±3.03. The mean postoperative range of motion score for group A was 15.88±5.07 and for group B it was 19.41±4.96. The mean postoperative hand grip strength score for group A was 15.88±4.76 and for group B it was 17.94±4.70. The mean postoperative radiological fracture union score according to scaphoid fracture union grading scale for group A was 2.24±0.75 but for group B it was 1.53±0.72. The mean postoperative patient satisfaction score according to MMWS for group A was 21.18±3.76 and for group B it was 21.76±2.46. Conclusions: Both techniques of close reduction and percutaneous fixation or open reduction and internal fixation are reliable options with no superiority of each regarding modified mayo wrist score.