Compression Screws in the Treatment of Fractures: A Scoping Review

Abstract

The purpose of this scoping review was to identify and describe the current body of evidence on internal fracture fixation devices that require compression screws. Electronic literature searches were conducted and 665 unique studies were included. Investigations on avulsion fractures represented a small proportion of these studies (45 studies), the remainder being those on patients with fractures with vascular compromise risk. The most common type of avulsion injury investigated was tibial avulsion fractures, followed by fifth metatarsal and calcaneal avulsions. For vascular compromised fractures, greater than half of the studies were on femoral neck injuries while scaphoid injury studies also represented a substantial proportion of this evidence base. Most of the studies were case series and there was limited randomized clinical trial evidence. A total of 429 studies provided sufficient information on the devices used in their investigation; DePuy-Synthes and Acumed ranked as the top two companies in cumulative publications over the last decade. There is a large body of evidence on internal fixation compression screw devices used in the management of fractures; however, the literature is generally dominated by non-comparative research studies. Opportunities to improve the evidence base are large. Manufacturer priority on evidence-based product development is key to ongoing research inquiry.