• THAKUR SK Orthopeadician, Jalandhar, Punjab, India
  • CHOUDHARY SK Orthopeadician, Jalandhar, Punjab, India
  • JOSEPH J B MAL Assistant Professor, Department of Orthopeadics, Punjab Institute of Medical Sciences, Jalandhar, Punjab, India
  • HIREMATH RN Public Health Specialist, Bangalore, Karnataka, India



Scaphoid fracture., Primary bone grafting, K wire fixation


Objective: The Objective of this study is to analyze the radiological, clinical and functional outcome of patients with acute unstable scaphoid fracture treated with primary bone grafting and K (Kirschner)-wire fixation

Methods:Based on inclusion and exclusion criteria , a prospective observational study was carried out on 21 patients with acute unstable  scaphoid fracture who had been treated with primary bone grafting and K-wire fixation from November 2017 to March 2020 and were followed up for a minimum of 24 weeks. The average patient age was 26.9 years. The time from injury to treatment averaged 11days. Surgery was done under Bier’s Block using volar approach. Bone graft was harvested from distal Radius. The mean operating time was 24 minutes.Clinical parameters like tenderness, grip strength and Range of Movement (ROM) at wrist was assessed. The functional outcome was evaluated using Modified Mayo wrist score. Bone union was assessed using serial plain radiographs.

Results:Union was achieved in all (100%) at 12 weeks. There was no evidence of Avascular necrosis (AVN) or arthrosis at latest follow up. As per Modified Mayo wrist score, there were 15 excellent,03 good and 03 fair results at the final follow-up. Individuals resumed their routine work at 12 weeks and all were comfortable with heavy works/ sports activity by 24 weeks.

Conclusion: Primary bone grafting has a definite role in the management of acute unstable scaphoid fracture by which aquicker and higher rate of union isachieved with minimal complications. Open reduction allows thorough assessment of fracture for better anatomic reduction. Although the type of fixation device hardly contributes for quicker and higher union, but then the use of K-wire for fixation is the only viable option for smaller bony fragments and is more forgiving in terms of its positioning. It has an added advantage in terms of requirement of minimal inventory and thus is a cost-effective modality. This procedure also confirms that the patients could get back to their work earlier hence decreasing economic burden.


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Gaebler C, McQueen MM. Carpus fractures and dislocations. In: Bucholz RW, Court-Brown CM, Heckman JD, Tornetta P, editors. Rockwood and Green’s Fractures in Adults. 8th ed. Philadelphia, PA: Lippincott Williams and Wilkins; 2015. p. 1008-31.

Clementson M, Björkman A, Thomsen NO. Acute scaphoid fractures: Guidelines for diagnosis and treatment. EFORT Open Rev 2020;5:96-103.

Kawamura K, Chung KC. Treatment of scaphoid fractures and nonunions. J Hand Surg Am 2008;33:988-97.

Suh N, Grewal R. Controversies and best practices for acute scaphoid fracture management. J Hand Surg Eur Vol 2018;43:4-12.

Sameh A. Fadl E, Salama K. Percutaneous fixation of acute scaphoid fractures. Egypt Orthop J 2013;48:385-38.

Rhemrev SJ, Ootes D, Beeres FJ, Meylaerts SA, Schipper IB. Current methods of diagnosis and treatment of scaphoid fractures. Int J Emerg Med 2011;4:4.

Brogan DM, Moran SL, Shin AY. Outcomes of open reduction and internal fixation of acute proximal pole scaphoid fractures. Hand 2015;10:227-32.

Khan MA, Akbar BP, Narender RJ, Chinnala SK. Open reduction and fixation of scaphoid fracture with bone grafting to avoid nonunion. Int J Rec Sci Res 2017;8:16153-5.

Palmer AK. Triangular fibrocartilage complex lesions: A classification. J Hand Surg Am 1989;14:594-606.

Cheung JP, Tang CY, Fung BK. Current management of acute scaphoid fractures: A review. Hong Kong Med J 2014;20:52-8.

Jiang Z, Cui J, Gong X, Lu L. Internal fixation with K wire is as efficient as rigid screw fixation in scaphoid fracture: Long term functional outcome. Acta Orthop Belg 2018;84:99-104



How to Cite

THAKUR SK, CHOUDHARY SK, JOSEPH J B MAL, and HIREMATH RN. “PRIMARY BONE GRAFTING AND K-WIRE FIXATION: A PREFERABLE OPTION TO TREAT ACUTE UNSTABLE SCAPHOID FRACTURE”. Asian Journal of Pharmaceutical and Clinical Research, vol. 14, no. 9, Sept. 2021, pp. 53-56, doi:10.22159/ajpcr.2021.v14i9.42217.



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