Percutaneous treatment for waist and proximal pole scaphoid fractures

Abstract

ObjectiveAnalyze the percutaneous fixation technique for scaphoid fractures in the waist of the scaphoid and the proximal pole, and demonstrate its result.MethodsA retrospective cross-cohort study conducted from January 2005 to April 2015, aiming at the consolidation time, epidemiological profile, level of function, return to work, and complications.ResultsTwenty-eight patients were selected, with a mean of eight weeks of follow-up. They presented a mean age of 30.5 years, male prevalence (25 patients; 89.2%), and no differences between dominant and non-dominant sides. The mean time from diagnosis was 4.16 weeks, but in three cases of fibrous union, the pre-operative period was over one year. The most frequent mechanism of injury was a fall on the outstretched hand, in 22 cases (78.5%). Of all fractures, 24 cases were in the waist (85.8%) and four were of the proximal pole (14.2%); seven patients had displacement (25%). There was consolidation in 26 cases (92.8%) with a mean of 7.5 weeks after surgery. In cases of non-union, radiological follow-up was up to 24 weeks, requiring a new surgical intervention.ConclusionsPercutaneous fixation is an excellent, reproducible technique that allows early active mobility of the wrist with a low complication rate, although it requires a learning curve.

Results of Percutaneous Fixation of Acute Scaphoid Fractures by Herbert Screw

“…Regarding epidemiology, the mean age of participants was 34.5±8.37. the majority of cases were male (67%) with right side prevalence (78%) and fall on outstretched hand was the major cause (67%), These results are similar to that reported by Severo et al (7) , who performed percutaneous treatment for 28 patients in which the mean age was 30.5 years, male prevalence was 89.2% with no prevalence of the dominant side and fall on the wrist was the main cause (78.5%).…”

“…These results are in line with the studies by Severo et al (7) who reported 92.80% excellent outcome, good (0%), fair (0%), and (7.20%) Poor result.…”

“…Severo et al (7) , included only patients with isolated scaphoid fractures with longer time of presentation 4.16 weeks (range 1-8 weeks). On the contrary, in our study the time of presentation was less than 3 ws range from (0.2-3 weeks) and presence of an associated injuries was not considered an exclusion factor.…”

Volar Percutaneous Fixation by Herbert Screw Versus Conservative Treatment for Stable Waist Scaphoid Fracture

“…All of the cases were recent fractures lasting less than three weeks. Severo et al [14], on the other hand, performed percutaneous treatment for 28 patients with a mean age of 30.5 years, a male prevalence of 89.2%, no prevalence of the dominant side, and a wrist fall as the primary aetiology (78.5%). Only patients with solitary scaphoid fractures and a longer period to presentation (4.16 weeks) were considered (range 1-8 weeks).…”