What Are the Common Applications of Cannulated Screws in Fracture Fixation?

When it comes to treating fractures, particularly in orthopedic surgery, the choice of fixation device plays a crucial role in promoting proper healing and functional recovery. One such device that has become a mainstay in modern fracture management is the cannulated screw. Known for its hollow core, this screw type has revolutionized the way surgeons address various fractures.

What Are Cannulated Screws?

Cannulated screws are designed with a hollow shaft, enabling them to be inserted over a guidewire. This unique design offers several advantages, especially when precision and minimally invasive techniques are required. Surgeons can accurately position the screw, ensuring optimal fixation with minimal soft tissue disruption.

What Are the Common Applications of Cannulated Screws?

Cannulated screws have several advantages over other orthopedic screws. Here are some of the common orthopedic surgical procedures in which these scares are used:

Hip Fractures: A Common Application

Perhaps the most frequent application of cannulated screws is in the fixation of femoral neck fractures, particularly in younger patients or those with non-displaced or minimally displaced fractures. The ability to precisely insert multiple cannulated screws over guidewires allows for secure fixation of these fractures. This approach preserves blood supply to the femoral head and reduces the risk of avascular necrosis, a serious complication in hip fractures.

Fixation of Scaphoid Fractures

Another area where cannulated screws shine is in the management of scaphoid fractures in the wrist. Due to the scaphoid’s unique blood supply and the risk of non-union, achieving stable fixation is paramount. Cannulated screws enable surgeons to achieve accurate, headless compression fixation, which promotes healing and preserves wrist function.

Ankle and Foot Fractures

In the realm of foot and ankle surgery, cannulated screws are commonly used for fixation of fractures of the medial malleolus, calcaneus, and talar neck. Their ability to be inserted percutaneously minimizes soft tissue damage, an important consideration given the limited soft tissue coverage in these regions. In addition, the screws’ cannulated design allows for precise placement in these small, complex bones.

Pediatric Fractures

Children with certain fractures, such as slipped capital femoral epiphysis (SCFE), also benefit from the use of cannulated screws. SCFE is a condition where the femoral head slips off the neck of the bone at the growth plate. Cannulated screws allow for in situ fixation, stabilizing the slip and preventing further displacement while minimizing the risk of growth plate damage.

Complex Fractures and Osteotomies

Cannulated screws are not limited to straightforward fractures. In complex fractures, such as tibial plateau fractures, these screws are often used in conjunction with plates to provide interfragmentary compression. Moreover, in osteotomies—surgical cutting and realignment of bones—cannulated screws offer reliable fixation that promotes bone healing and maintains the desired alignment.

Why Surgeons Prefer Cannulated Screws?

The popularity of cannulated screws can be attributed to several key factors. First, the ability to use a guidewire simplifies the surgical technique, particularly in difficult-to-reach locations. Second, because the screws can be inserted percutaneously, they allow for minimally invasive approaches that reduce postoperative pain and shorten recovery times.

Additionally, the screws’ design often allows for compression across the fracture site, which is crucial for promoting bone healing. In many cases, these screws are made of titanium or stainless steel, materials that offer excellent strength while being biocompatible and resistant to corrosion.

Conclusion

Cannulated screws have become a go-to solution in modern orthopedic surgery, thanks to their precision, versatility, and minimally invasive application. From hip fractures to wrist injuries and beyond, these screws play an essential role in stabilizing fractures and enabling patients to return to their daily activities. Their continued use and refinement reflect the ongoing commitment in orthopedics to improve patient outcomes and reduce the burden of fractures. As surgical techniques and other orthopaedic implants evolve, cannulated screws are likely to remain a staple in the toolkit of orthopedic surgeons worldwide.