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PERCUTANEOUS AO SCREW FIXATION OF CARPAL SCAPHOID FRACTURES



Abstract

The scaphoid fractures treated in our series are classified as type A1, B1 and B2 according to the Herbert classification. We analyse the advantages of the percutaneous technique in comparison to the open reduction technique, as well as the advantages in comparison to conservative treatment. A total of 36 patients (33 males; three females) with scaphoid fractures were treated by the percutaneous technique, by insertion of a 3-mm AO screw and a 5.5-mm washer. Of these, 35 patients had an acute fracture and one patient had suffered the fracture 1 month prior to treatment. Mean age was 30.9 years (range 14–64 years). One patient had an associated radial fracture, and one patient suffered multiple fractures of the upper extremity. The fractures were classified according to Herbert as follows: type A2, n=7; type B1, n=7; and type B2, n=22. Of the 36 patients, 33 returned for follow-up. Mean follow-up was 23 months (range 3–39 months). Duration of surgery was an average of 40 min (range 18–70 min). Results were evaluated according to a scheme that analysed pain, mobility, strength, radiographic consolidation of fracture fragments, return to work or sport activities. Our results were optimal in 28 patients, good in 5. We did not observe any cases of non-union or infection.