Percutaneous screw fixation of nondisplaced or reducible scaphoid fractures has become
more popular as techniques and implants have improved. Many authors have advocated
for the dorsal approach, citing difficulties with adequate screw placement from the
volar approach. We have developed a straightforward and reproducible technique for
volar percutaneous scaphoid screw fixation that mitigates most of the drawbacks of
the approach. The wrist is held in extension and ulnar deviation with traction through
the thumb. A 14-gauge angiocatheter needle is then used to localize the starting point
and as a cannula for the guide wire. Specific fluoroscopic views help to confirm optimal
guide wire placement.
Key words
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References
- Comparison of short and long thumb-spica casts for non-displaced fractures of the carpal scaphoid.J Bone Joint Surg. 1989; 71A: 354-357
- Percutaneous screw fixation or cast immobilization for nondisplaced scaphoid fractures.J Bone Joint Surg. 2001; 83A: 483-488
- Comparison of percutaneous dorsal versus volar fixation of scaphoid waist fractures using a computer model in cadavers.J Hand Surg. 2009; 34A: 1838-1844
- Percutaneous screw fixation for scaphoid fracture: a comparison between the dorsal and the volar approaches.J Hand Surg. 2009; 34A: 228-236
- Percutaneous fixation of scaphoid fractures.J Hand Surg. 1999; 24B: 85-88
- Percutaneous fixation of the scaphoid Through a dorsal approach: an anatomic study.J Hand Surg. 2008; 33A: 327-331
- Pronated oblique view in assessing proximal scaphoid articular cannulated screw penetration.J Hand Surg. 2008; 33A: 1274-1277
- Complications in dorsal percutaneous cannulated screw fixation of nondisplaced scaphoid waist fractures.J Hand Surg. 2007; 32A: 827-833
- Central screw placement in percutaneous screw scaphoid fixation: a cadaveric comparison of proximal and distal techniques.J Hand Surg. 2004; 29A: 74-79
- Central placement of the screw in simulated fractures of the scaphoid waist: a biomechanical study.J Bone Joint Surg. 2003; 85: 72-77
- Percutaneous transtrapezial fixation of acute scaphoid fractures.J Hand Surg. 2008; 33A: 791-796
- Biomechanical assessment of compression screws.Clin Orthop Relat Res. 1998; 350: 237-245
- Percutaneous cannulated screw fixation of acute scaphoid waist fracture.J Hand Surg. 2002; 27B: 42-46
- Internal fixation of acute, nondisplaced scaphoid waist fractures via a limited dorsal approach: an assessment of radiographic and functional outcomes.J Hand Surg. 2007; 32A: 326-333
Article info
Publication history
Accepted:
February 23,
2011
Received:
February 22,
2011
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2011 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
