Abstract

Background: Scaphoid fracture is the most common among carpal bone fractures, frequently imperceptible on initial radiographs. There is general consensus on the treatment of fractures of the proximal pole of the scaphoid and delays of consolidation and nonunion, entities are treated surgically.In present study, we aimed to compare functional outcome of scaphoid fracture treated by open reduction internal fixation vs percutaneous fixation.
Material and Methods: Present study was a prospective, observational & randomised study conducted in patients of age group 21-60 years, acute (<3 days), displaced scaphoid fracture (> 1 mm), willing to participate in study & follow up.
Results: 28 cases were divided into ORIF group (open reduction internal fixation) or PF (percutaneous fixation) group as 14 cases each. Mean age, gender, laterality & mode of trauma were comparable in both groups & difference was not significant statistically. After evaluation, patients were classified as per Herbert Classification. Distribution was comparable in both groups & difference was not significant statistically In present study, Mayo wrist score was significantly better in PF group at 4, 8, 12 & 16 weeks as compared to groups & difference was significant statistically (p< 0.05). While at 20 & 24 weeks, Mayo wrist score was comparable in both groups & difference was not significant statistically (p> 0.05). At 24 weeks, Radiological outcome was grade 1 in 12 & 11 patients among ORIF group (open reduction internal fixation) & PF (percutaneous fixation) group respectively & difference was not significant statistically (p> 0.05).
Conclusion: Percutaneous fixation of acute, displaced scaphoid fractures with percutaneous Herbert screws is an effective treatment which reduces the need of prolonged immobilization and helps in an early return to the routine activity as compared to open reduction & internal fixation.