Kết quả điều trị gãy kín xương thuyền bằng vít nén tại Bệnh viện Trung ương Quân đội 108

Abstract

Objective: To evaluate the outcomes of internal fixation of closed scaphoid fractures using headless compression screws at the 108 Military Central Hospital. Subject and method: This study included 30 patients with closed scaphoid fractures treated surgically with compression screws at the Department of Orthopedic Trauma, 108 Military Central Hospital, from January 2021 to March 2025. According to the Herbert classification: Group I (acute fractures, n = 5), Group II (delayed union, n = 13), and Group III (nonunion, n = 12). Most nonunion cases (> 6 months) were managed with vascularized bone grafts from the distal radius (8/12 cases). Outcomes were assessed based on radiographic union, wrist range of motion, grip strength, Mayo Wrist Score, Visual analogue scale (VAS) and complications. Result: The overall union rate was 96.7% (29/30). Group I achieved 100% union; Groups II and III each had one case of delayed union, and Group III, one of twelve cases developed nonunion - initially treated with cancellous bone grafting àn later revised using a vascularized bone grafting. The mean time to union was 8.2 ± 1.3 weeks in Group I, 13.9 ± 3.3 weeks in Group II, and 16.8 ± 3.3 weeks in Group III. The mean Mayo Wrist Score was 81.0 ± 9.0, with good or excellent outcomes in 66.7% of patients. Conclusion: Surgical fixation of closed scaphoid fractures with headless compression screws yielded favorable results in terms of union and functional recovery. In nonunion cases, vascularized bone grafting from the distal radius proved to be an effective adjunct, contributing to improved union rates.