Scientific articlePercutaneous Screw Fixation for Scaphoid Fracture: A Comparison Between the Dorsal and the Volar Approaches
Section snippets
Materials and Methods
From January 1999 to December 2005, we prospectively followed up 53 patients with an acute scaphoid fracture. All fractures were classified according to the modified classification of Herbert and Fisher.23 All fractures were classified as type B2 unstable acute fractures (22 fractures in the dorsal group and 19 fractures in the volar group). Mild comminution in the palmar side was noted in 4 patients. All patients were managed with percutaneous screw fixation by 1 hand surgeon at the university
Clinical results
The demographics of the 2 groups were very similar according to age, gender, time between injury and surgery, and follow-up time (Table 1). Most subjective pain was reduced by internal fixation of the scaphoid 2 or 3 days postoperatively. The outcome measurements of pain, tenderness, range of motion, grip strength, and Mayo wrist score are shown in Table 2. The 2 groups were similar at the baseline for all outcome measurements and the mean follow-up period (Table 1). Overall, the final range of
Discussion
Nondisplaced fractures of the scaphoid waist were managed with immobilization as the standard treatment; however, unstable and displaced scaphoid fractures when treated with plaster immobilization are at the greatest risk of nonunion.25 Reports on open internal fixation of scaphoid fractures have documented a high rate of union,26, 27 but there are risks of violating intact volar ligaments and, subsequently, carpal instability.28, 29 In addition, surgical trauma of the soft tissue around the
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Postoperative Imaging of the Wrist and Hand
2022, Magnetic Resonance Imaging Clinics of North AmericaCitation Excerpt :Percutaneous screw fixation is done under fluoroscopic control via palmar or dorsal approach. Dorsal approach allows placement of the screws more parallel to the long axis of the scaphoid.30 Old untreated scaphoid fractures or nonunited fractures are usually an indication for treatment.
How to manage scaphoid waist fractures? Introduction of pragmatic imaging efficient pathway and literature review of the recent evidence
2021, Journal of Medical Imaging and Radiation SciencesCitation Excerpt :Fracture with the scapholunate angle of more than 60 or less than 30 and proximal pole fracture also requires surgical fixation [32,33]. Surgical options included percutaneous or open reduction and internal fixation (ORIF) using headless compression screws through a volar or dorsal approach [33–36]. This pathway was reviewed and approved in the departmental governance meeting before its implementation.
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