Percutaneous screw fixation with bone marrow injection in delayed fracture scaphoid, is it effective: a randomized control study

Abstract

Background Scaphoid is the most commonly injured carpal bone, with over two-thirds of scaphoid fractures occurring at the waist. The anatomy of the scaphoid makes these injuries susceptible to delayed unions or nonunions and can lead to significant morbidity and disability. Aim To evaluate the effect of bone marrow injection on bone healing in delayed presented fractures of scaphoid with percutaneous fixation via Herbert screw. Patient and methods Forty patients with delayed presented scaphoid fractures treated with percutaneous screw fixation and divided into two groups, group A augments the fixation with bone marrow injection, while group B suffices with fixation only. Results All fractures had complete union, but there is a significant acceleration in bone healing in group A than in group B with P value less than 0.05. This is reflected in the other results for group A, according to Mayo wrist score, we have 17 excellent and three good results, while in group B, there were 15 excellent, four good, and one patient with poor results due to nonunion that occurred. Conclusion The use of bone marrow is considered a simple and minimally invasive technique. It is safe and has no risk, so we recommend use of bone marrow injection with fixation of delayed presented fractures of scaphoid.