Percutaneous Screw Fixation for Scaphoid Fracture: A Comparison Between the Dorsal and the Volar Approaches

Percutaneous fixation of selected scaphoid fractures by dorsal approach

“…Complications were also reported related to both methods of fixation [11]. Injury to the superficial branch of the radial artery, delayed union, complex regional pain syndrome, and infection using the palmar approach have been reported in literature [11,25].…”

“…The axes and angles were measured manually. The long axis of the scaphoid in the posteroanterior was defined as a line between the centre of the distal tuberosity and the most convex point of the proximal pole of the scaphoid, and the long axis of the scaphoid was determined as the palmar outline in the lateral view [11]. The radiological assessment involved finding the relationship between the long axis of the Herbert screw with respect to the long axis of the scaphoid and the fracture line with respect to the long axis of the Herbert-Whipple screw on the posteroanterior (Fig.…”

“…The importance of screw position in the scaphoid has been emphasised by various authors [10,11]. The central placement of the screw in the proximal fragment of the scaphoid is associated with excellent clinical outcome.…”

“…Injury to the superficial branch of the radial artery, delayed union, complex regional pain syndrome, and infection using the palmar approach have been reported in literature [11,25]. However, there has been controversy about the complication rate in the dorsal approach, with some authors [26] reporting it to be higher than others [27].…”

“…However, there has been controversy regarding the best approach for these fractures and many studies have been carried out to find out which one is the best [9][10][11]. We felt that the dorsal approach is very useful in fixation of body and waist fractures of the scaphoid as securing a purchase with the screw in the distal third of the scaphoid in more distal fractures is difficult with this approach.…”