The Scaphoid Staple: A Systematic Review

Background: The purpose of this systematic review is to analyze the indications, outcomes, and complications of scaphoid fixation with a staple. Methods: The literature was reviewed for all cases of the scaphoid staple. Five articles including 188 patients, of 77 primary scaphoid fractures and 111 other indications that included delayed union, nonunion, and avascular necrosis, were reviewed. Demographic data, outcomes, and complications were recorded. Results: The union rate of the scaphoid staple is 94.7%, and 95.7% of patients return to work after an average of 9.8 weeks after a 4.7-week period of immobilization. The complication rate was 9.0%, and 7.5% required hardware removal. Clinical and radiographic healing was higher in primary fractures as compared with other indications. Other indications, as compared with primary fracture, had a higher rate of hardware removal. Conclusions: For all indications, the scaphoid staple has a high union rate and a low complication rate. In the authors’ experience, the procedure is fast, not technically challenging, and may be considered for primary fracture, delayed union, nonunion, and avascular necrosis of the scaphoid.