Comparison of Five Headless Screws for Fixation of Small Bones

Headless screws are favored for internal fixation in the treatment of displaced or unstable small bone (e.g., Scaphoid) fractures, because they are embedded below the articular surface of the bone, reducing tissue irritation and immobilization. Compression plays an important role in fracture stability, maintaining gap reduction and also accelerating the healing of cancellous bone [1]. There are several types of screws being used in practice and it is of clinical interest to know how different they are in generating and maintaining the compression force. Several studies have investigated the compressive forces of headless screws [2,3]. However, little attention has been paid to the fastening torque and the effect of pre-drilling. This study compares the generated compression force and fastening torque and the effect of pre-drilling during the insertion of five frequently used headless compression screws that are typically used for scaphoid fixation.