Comparison of volar plating and headless compression screw for fixation of scaphoid nonunion: a meta-analysis of comparative studies

Abstract

Abstract This study compared the clinical and radiological outcomes of volar plating versus headless compression screw fixation for scaphoid nonunion using a meta-analysis. A comprehensive search of PubMed, Cochrane Library, and EMBASE databases was conducted to identify comparative studies evaluating volar plating versus headless compression screw fixation for scaphoid nonunion. Pooled analyses assessed union rate, time to union, range of motion, grip strength, Disabilities of the Arm, Shoulder, and Hand (DASH) score, and hardware-related complications. Seven studies (two prospective and five retrospective studies) involving 226 participants were analyzed. Pooled analysis showed comparable high union rates between volar plating and headless compression screws. Plate fixation was associated with a significantly shorter time to union. The rate of implant removal owing to symptoms or implant-related complications was higher in the plate fixation group. Extension range of motion was decreased in patients treated with plate fixation, whereas grip strength and DASH scores were similar between the groups. Overall, both fixation methods showed comparable union rates and functional outcomes, while volar plating was associated with a shorter time to union but higher implant removal rates.