{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T23:34:42Z","timestamp":1792971282906,"version":"4.5.0"},"reference-count":15,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T00:00:00Z","timestamp":1778025600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Hand Surg Eur Vol"],"published-print":{"date-parts":[[2026,11]]},"abstract":"\n Introduction:<\/jats:title>\n Displaced scaphoid fractures warrant surgical fixation to mitigate the risk of nonunion or malunion. We hypothesized that two-screw fixation would result in higher rates of union at shorter times.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n We retrospectively reviewed data of patients who presented with scaphoid fractures and underwent surgical fixation between 1 January 2013 and 30 November 2024. Patients were propensity score matched using demographics and Herbert classification as covariates.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n After propensity score matching, 92 patients were identified, 47 receiving one screw and 45 receiving two screws. At 6\u2009months after surgery, wrist extension was significantly greater in the one-screw cohort than in the two-screw cohort (71.0\u00b0, standard deviation (SD) 10.7\u00b0 vs. 56.2\u00b0, SD 20.5\u00b0,\n p<\/jats:italic>\n \u2009=\u20090.03); all other range of motion variables were similar between the cohorts at this timepoint. Visual analogue scale scores postoperatively significantly improved compared with preoperatively for both cohorts (\n p<\/jats:italic>\n \u2009<\u20090.001 for both). Patients in the one-screw cohort showed significant improvements in Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Interference (PI) and Physical Function scores after surgery as compared with before surgery. The PROMIS PI scores in the two-screw cohort also showed significant differences after and before surgery. Rates of nonunion, time to union and hardware complications did not show statistically significant differences between the one- and two-screw cohorts.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n In this study, we reject our hypothesis as two screws were similar to one-screw fixation for rates of healing and outcomes.<\/jats:p>\n <\/jats:sec>\n \n Level of evidence:<\/jats:title>\n III, case-control study<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/17531934261445802","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T05:59:54Z","timestamp":1778133594000},"page":"1285-1295","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Role of one- versus two-screw fixation of scaphoid fractures in contributing to nonunion and delayed union"],"prefix":"10.1177","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-4237-1718","authenticated-orcid":false,"given":"Crystal","family":"Jing","sequence":"first","affiliation":[{"name":"School of Medicine, Duke University, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian F","family":"Zirbes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia E","family":"Ralph","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Mwangi","sequence":"additional","affiliation":[{"name":"School of Medicine, Duke University, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tyler S","family":"Pidgeon","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Duke University Medical Center, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Warren C","family":"Hammert","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Duke University Medical Center, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,5,6]]},"reference":[{"key":"e_1_3_3_2_1","first-page":"73","article-title":"Single versus double screw fixation for the treatment of scaphoid waist fractures: finite element analysis and preliminary clinical results in scaphoid nonunion","volume":"31","author":"Acar B","year":"2020","unstructured":"Acar B, K\u00f6se \u00d6, Turan A, Kat\u0131 YA, G\u00fcler F. Single versus double screw fixation for the treatment of scaphoid waist fractures: finite element analysis and preliminary clinical results in scaphoid nonunion. Jt Dis Relat Surg. 2020, 31: 73.","journal-title":"Jt Dis Relat Surg"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2020.10.012"},{"key":"e_1_3_3_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/15589447221081879"},{"key":"e_1_3_3_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2014.02.030"},{"key":"e_1_3_3_6_1","unstructured":"Greifer N. Matchit. 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The factors affecting outcome after non-vascular bone grafting and internal fixation for nonunion of the scaphoid. J Bone Joint Surg Br. 2007, 89: 627\u201332.","journal-title":"J Bone Joint Surg Br"},{"key":"e_1_3_3_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2022.03.009"},{"key":"e_1_3_3_16_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199612000-00005"}],"container-title":["Journal of Hand Surgery (European Volume)"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17531934261445802","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/17531934261445802","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17531934261445802","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T23:00:44Z","timestamp":1792969244000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/17531934261445802"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,6]]},"references-count":15,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["10.1177\/17531934261445802"],"URL":"https:\/\/doi.org\/10.1177\/17531934261445802","relation":{},"ISSN":["1753-1934","2043-6289"],"issn-type":[{"value":"1753-1934","type":"print"},{"value":"2043-6289","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,6]]}}}