Minimally Invasive Percutaneous Fixation of Non-United Scaphoid Fractures

Abstract

Background: Scaphoid non-unions pose a great challenge to surgeons because of the multiple factors that may contribute to their causation.The etiology of the nonunion may be because of anatomic variations, fracture configuration, vascular problems, underlying metabolic problems, or the inadequacy of initial treatment.Percutaneous management of scaphoid non-unions offers the advantage of inducing minimal trauma to the soft tissues while adequately stabilizing the fracture site to induce union in a high percentage of cases.This study proves that percutaneous fixation of delayed or nonunited scaphoid fractures result in predictable satisfactory union rate and functional outcome, it proves that percutaneous Herbert's screw insertion carries no risk of damage to soft tissues or vascular supply. Also, the gap is not the determinant of time to union but actually it is the time since injury; the longer the time since injury the longer the time to union as long as the scaphoid alignment is maintained i.e. no humpback deformity.