- Percutaneous Fixation:
- in the report by CD Bond et al 2001, the authors evaluated 25 patients with acute nondisplaced fracture
of the
scaphoid waist that consented to be randomized to either cast immobilization or fixation
with a percutaneous cannulated screw fixation;
- 11 patients were randomized to percutaneous cannulated screw fixation, and 14 were randomized to cast immobilization;
- technical considerations:
- it is essential that the guide wire remain centrally locally in the distal fracture fragment on the
AP, lateral, and oblique views;
- the trapezium will tend to block the path of the guide wire away from the ideal path;
- by extending the supiated wrist and by applying traction on the thumb, the trapezium will be translated
dorsal to the scaphoid, which allows proper insertion of the guide wire;
- average time to fracture union in the screw fixation group was 7 weeks compared with twelve weeks in the cast immobilization group; (p = 0.0003).
- average time until the patients returned to work was 8 weeks compared with 15 weeks in the cast immobilization group (p = 0.0001);
- there was no significant difference in the range of motion of the wrist or in grip strength at the two-year follow-up evaluation;
- percutaneous cannulated screw fixation of nondisplaced scaphoid fractures resulted in faster radiographic union and return to work compared with cast immobilization;
Percutaneous Screw Fixation or Cast Immobilization for Nondisplaced Scaphoid Fractures CD. Bond, MD et al. The Journal of Bone and Joint Surgery 83-A:483 (2001)
A technical note on percutaneous scaphoid fixation using a hybrid technique.
Percutaneous screw fixation for unstable scaphoid fractures.
Internal Fixation of Acute, Nondisplaced Scaphoid Waist Fractures Via a Limited Dorsal Approach: An Assessment of Radiographic and Functional Outcomes.
Complications in Dorsal Percutaneous Cannulated Screw Fixation of Nondisplaced Scaphoid Waist Fractures
Anthropometry of the Human Scaphoid
Percutaneous Fixation of the Scaphoid Through a Dorsal Approach: An Anatomic Study
