Comparison of Kirschner Wire Versus Screw Fixation in 1,2 Inter-Compartment Supra Retinaculum Artery Pedicle-Vascularized Bone Graft for Scaphoid Fractures

Introduction: The purpose of the study was to compare the outcomes of the Kirschner wires (k-wires) versus screw fixation in 1,2 inter-compartment supra retinaculum artery (ICSRA) pedicle-vascularized bone graft for scaphoid non-union treatment. Method: A retrospective study that included all patients with scaphoid nonunion underwent pedicle-vascularized bone graft and fixated with either k-wire or screw from 2010 through 2019 in the Department of Plastic and Reconstructive Surgery at Liaquat National Hospital and Medical College. Clinical outcomes were compared between k-wire and screw fixation, which were measured in terms of union rate, time of healing, pre and post-operative Disabilities of the Arm, Shoulder, and Hand (DASH) scores, range of motion at wrist, and grip strength of hand. Results: A total of 33 patients were included in the study. All of them had scaphoid non-union and were treated with 1,2 ICSRA pedicle-vascularized bone graft; 20 patients had a fixation with k-wire and 13 with a screw. Radiological healing was achieved in 18 patients with k-wire and 11 patients with screw fixation, with healing rates of 90% and 84.6%, respectively. There was a significant decrease in DASH score postoperatively in both groups. Although no significant difference between the outcomes of both groups whether on union rate, DASH score, or range of motion at the wrist. Conclusion: Hence, there is no significant difference in outcome between k-wire and screw fixation methods. We concluded k-wire as a more acceptable option with vascularized bone graft fixation as less technically demanding and low cost as compared to screw fixation.