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Joint Diseases and
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Original Article · Open access

Enhanced scaphoid fixation with Kirschner wire: A clinical and finite element study

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İbrahim Halil Dadir

Department of Orthopedics and Traumatology, Polatlı Duatepe State Hospital, Ankara, Türkiye

ORCID: 0000-0002-7892-1745

Enejd Veizi

Department of Orthopedics and Traumatology, Ankara Bilkent City Hospital, Ankara, Türkiye

ORCID: 0000-0002-1289-4959

Uğur Bezirgan

Department of Hand Surgery, Ankara University Faculty of Medicine, Ankara, Türkiye

ORCID: 0000-0001-9053-8637

Mustafa Bilgiç

Trmotor Power Systems San A.Ş., Aeronautical and Space Engineering, Ankara, Türkiye

ORCID: 0009-0003-2000-5239

Şahin Çepni

Department of Orthopedics and Traumatology, Ankara TOBB University of Economics and Technology Faculty of Medicine Hospital, Ankara, Türkiye

ORCID: 0000-0001-6850-7439

Erdinç Acar

Department of Orthopedics and Traumatology, Ankara Bilkent City Hospital, Ankara, Türkiye

ORCID: 0000-0002-2154-0108

Abstract

Objectives: This study aims to assess the effect of addition of a Kirschner wire (K-wire) to a headless compression screw on biomechanical and clinical outcomes in the treatment of scaphoid fractures and nonunions.

Patients and methods: Between January 2020 and November 2023, a total of 23 patients (20 males, 3 females; mean age: 29.7±7.2 years; range, 18 to 43 years) who underwent surgical treatment for scaphoid fractures and nonunion were retrospectively analyzed. The patients were divided into two groups: those who received only a headless compression screw (Group 1), and those who received both a screw and a supplementary K-wire, which was removed after three months (Group 2). In cases of nonunion, autografting was also performed. Postoperative clinical outcomes were evaluated using Visual Analog Scale (VAS), Mayo Wrist Score, and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH). Finite element analysis was conducted to assess the biomechanical performance of both fixation methods.

Results: Patients treated with screw combined with the K-wire demonstrated significantly improved postoperative functional scores and lower pain levels compared to those treated with screw alone (p=0.011 for VAS, p=0.027 for Mayo Wrist Score and p=0.009 for QuickDASH). Finite element analysis revealed a reduction in stress concentration at the fracture site in the screw + K-wire group.

Conclusion: The addition of a K-wire to screw fixation seems to enhance biomechanical stability and clinical outcomes in scaphoid fractures. These findings suggest that K-wire augmentation may be a beneficial strategy for improving healing and reducing postoperative discomfort.

Declarations

Author Contributions

Idea/concept: E.A., İ.H.D.; Design: E.A.; Control/supervision: E.V.; Data collection and/or processing, writing the article: İ.H.D.; Analysis and/or interpretation: E.V., M.B.; Literature review: İ.H.D., Ş.Ç.; Critical review: E.A., Ş.Ç.; References and fundings: İ.H.D., U.B.; Materials: U.B., E.A.; Other (finite element analysis/software support): M.B.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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