The Headless Compression Screw – Technical challenges in scaphoid fracture fixation

BackgroundThe Headless Compression Screw® (HCS) is a cannulated screw that is used for scaphoid fracture fixation. The screw generates compression across the fracture site prior to being countersunk below the articular surface.MethodsWe performed a retrospective review of 56 consecutive scaphoid fixations using this device in patients with both acute and chronic fractures.ResultsUnion rates were 100% in acute and 87% in chronic fractures. 16% of patients required screw removal for protrusion.ConclusionDespite placement of the screw in line with technical guidance, protrusion was significant and can be a source of ongoing morbidity.