Arthroscopic Reduction and Percutaneous Fixation of Scaphoid Fracture and Nonunion

Kim, Byung Sung; Chung, Dae Hak

Abstract

PURPOSE: To analyze the results of an arthroscopic reduction and percutaneous fixation of scaphoid fracture and nonunion.
MATERIALS AND METHODS
Fourteen scaphoid fractures or nonunion patients were analyzed clinically. There were 13 men and 1 woman, with a mean age of 30 (14-45) years. The average follow-up time was 13 months (12-18). Three cases had delayed union, 5 cases had nonunion and 6 cases had a fracture. After fluoroscopic reduction and an arthroscopic examination, the scaphoid was fixed with an Acutrak screw or K-wire percutaneously. The serial radiographs were checked by 2 weeks to confirm the bony union. The Mayo wrist score and DASH were used to assess the functional result at the final follow up.
RESULTS
Bony union was acquired in 13 cases in a mean time of 8 weeks. The mean Mayo wrist score was 86 points (60-100) with 7 excellent, 4 good, 2 fair and 1 poor case. The mean DASH was 11.1 points (0-63.3).
CONCLUSION
In scaphoid fracture and delayed union, good results could be obtained by an arthroscopic reduction and percutaneous fixation. However, in scaphoid nonunion, this technique should only be used in selected cases.