Percutaneous Screw Fixation for Acute Scaphoid Fractures Through K-wire-assisted Reduction and Maintenance

Percutaneous Screw Fixation for Acute Scaphoid Fractures Through K-wire-assisted Reduction and Maintenance

The scaphoid is the most common fractured carpal bone in active adults, accounting for up to 80% of all carpal fractures. The optimum treatment approach of the acute scaphoid fractures is under discussion. Cast immobilization is the main treatment for non-displaced scaphoid fractures, however, about 20% of scaphoid fractures fail to heal with conservative treatment. Long periods of cast immobilization may result in wrist stiffness, loss of grip strength, muscle atrophy and disuse osteopenia. Operative treatment for displaced and unstable scaphoid fractures was mostly adopted, however, open fixation for scaphoid fractures have the inherent disadvantages of ligament and capsular dissection, blood vessels damage. This study introduces a novel measures of percutaneous screw fixation for acute scaphoid fractures. We used one K-wire maintaining the reduction of the scaphoid fractures throughout the entire process of drilling and screw insertion and screw fixation for acute scaphoid fractures.

Inclusion Criteria:

• acute scaphoid fractures
• Injury to surgery less than 7 days
• Only one injured hand
• Written informed consent to undergo the surgical procedure
• Patients of either sex aged between 18 and 70 years

Exclusion Criteria:

• Patients with vascular injuried requiring revascularization
• Concomitant phalanx fractures or other injuries needing immobilization
• Loss of skin substance requiring grafts or flaps
• Uncompensated diabetes, neoplasia, haemocoagulative alterations, psychic disorders
• Smokers