Treatment of scaphoid waist fractures by shape memory staples. Retrospective evaluation on 60 cases

Objectives. - In carpal scaphoid fractures, treatment with screws is considered the gold standard: ostheosynthesis with mini-staples is not the usual choice of treatment. The authors report a study on fractures of the middle third of the scaphoid treated by mini shape memory staples, in order to test the quality of reduction and ostheosynthesis, functional results, time of union and complications. Materials and methods. - A retrospective analysis of 60 patients, with average age 39 years old and follow-up 36 months, was performed. Evaluation criteria were: the grade of pain, flexion-extension and pronation-supination wrist range, hand grip strength, radiographic consolidation of fractures and lateral intrascaphoid angle of flexion as described by Amadio. Results. - Pain was absent in 86% of the cases, the average flexion-extension range achieved was 107° and the average pronation-supination range 171°. Hand grip strength values achieved were comparable to those of the controlateral wrist in 85% of cases. Radiographic consolidation of the fracture was achieved in all patients within three months of surgery and the average value of the lateral intrascaphoid angle of flexion was 37°. No cases of algodystrophy were observed. Conclusions. - Our results show the safety and the practicality of ostheosynthesis with mini shape memory staples in fresh unstable fractures of the middle third of the scaphoid. Stable fixation, continuous compressive force on fragments and the ability to allow early active movement, are the main advantages. © 2005 Elsevier SAS. Tous droits réservés.