Advertisement

International Orthopaedics

, Volume 42, Issue 8, pp 1911–1916 | Cite as

A novel percutaneous achievement and maintenance of reduction and screw fixation for acute displaced scaphoid fractures: minimum two-year follow-up

  • Yadong Yu
  • Haibin Cui
  • Xiaoliang Yang
  • Xiaofei Yu
  • Yanbin Bai
Original Paper
  • 198 Downloads

Abstract

Purpose

The purpose of this study was to introduce a novel method of percutaneous achievement and maintenance of reduction for acute displaced scaphoid fractures and evaluate the feasibility of this method in treating acute displaced scaphoid fractures as well as explore its indications.

Methods

From February 2012 to March 2014, 15 patients with acute displaced scaphoid fractures were treated with our technique. Two Kirschner wires were used to achieve and maintain the reduction of the scaphoid fractures throughout the entire process of the traditional percutaneous screw fixation process. The following parameters including function scores according to modified Mayo wrist scoring system, range of motion (ROM) of the wrist, grip strength, pinch strength, healing time, time to return to work, and final outcomes were recorded.

Result

All patients were followed up with a mean period of 2.5 years (range, 2–3.5 years). All fractures healed with a mean of 9.3 weeks (range, 7–11.5 weeks). All patients returned to pre-injury level of activity within six weeks. The functional scores averaged 90.3 (range, 80–100). ROM of the wrist was equal to that of the contralateral side at three months postoperatively. Grip strength and pinch strength compared with contralateral were 98% and 92%, respectively. All were satisfied with the final outcomes.

Conclusions

Our technique is successfully performed in acute displaced scaphoid fractures resulting in shortened immobilization and prompt functional recovery. It broadens the indications of the percutaneous method, which means the advantages of the percutaneous method are maximally reserved whilst the drawbacks of open reduction were avoided.

Keywords

Percutaneous fixation Acute scaphoid fracture Displaced fracture Unstable fracture 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Garcia RM, Ruch DS (2014) Management of scaphoid fractures in the athlete: open and percutaneous fixation. Sports Med Arthrosc 22(1):22–28.  https://doi.org/10.1097/JSA.0000000000000008 CrossRefPubMedGoogle Scholar
  2. 2.
    Bond CD, Shin AY, McBride MT, Dao KD (2001) Percutaneous screw fixation or cast immobilization for nondisplaced scaphoid fractures. J Bone Joint Surg Am 83-A(4):483–488CrossRefPubMedGoogle Scholar
  3. 3.
    Grover R (1996) Clinical assessment of scaphoid injuries and the detection of fractures. J Hand Surg (Br) 21(3):341–343CrossRefGoogle Scholar
  4. 4.
    Eddeland A, Eiken O, Hellgren E, Ohlsson NM (1975) Fractures of the scaphoid. Scand J Plast Reconstr Surg 9(3):234–239CrossRefPubMedGoogle Scholar
  5. 5.
    Kim WC, Shaffer JW, Idzikowski C (1983) Failure of treatment of ununited fractures of the carpal scaphoid. The role of non-compliance. J Bone Joint Surg Am 65(7):985–991CrossRefPubMedGoogle Scholar
  6. 6.
    Herbert TJ, Fisher WE (1984) Management of the fractured scaphoid using a new bone screw. J Bone Joint Surg (Br) 66(1):114–123CrossRefGoogle Scholar
  7. 7.
    Wozasek GE, Moser KD (1991) Percutaneous screw fixation for fractures of the scaphoid. J Bone Joint Surg (Br) 73(1):138–142CrossRefGoogle Scholar
  8. 8.
    Dias JJ, Singh HP (2011) Displaced fracture of the waist of the scaphoid. J Bone Joint Surg (Br) 93(11):1433–1439.  https://doi.org/10.1302/0301-620X.93B11.26934 CrossRefGoogle Scholar
  9. 9.
    Amadio PC, Berquist TH, Smith DK, Ilstrup DM, Cooney WP 3rd, Linscheid RL (1989) Scaphoid malunion. J Hand Surg [Am] 14(4):679–687CrossRefGoogle Scholar
  10. 10.
    Hove LM (1999) Epidemiology of scaphoid fractures in Bergen, Norway. Scand J Plast Reconstr Surg Hand Surg 33(4):423–426CrossRefPubMedGoogle Scholar
  11. 11.
    Arsalan-Werner A, Sauerbier M, Mehling IM (2016) Current concepts for the treatment of acute scaphoid fractures. Eur J Trauma Emerg Surg 42(1):3–10.  https://doi.org/10.1007/s00068-015-0587-8 CrossRefPubMedGoogle Scholar
  12. 12.
    Cooney WP 3rd, Dobyns JH, Linscheid RL (1980) Nonunion of the scaphoid: analysis of the results from bone grafting. J Hand Surg [Am] 5(4):343–354CrossRefGoogle Scholar
  13. 13.
    Dickison J, Shannon J (1944) Fractures of the carpal scaphoid in the Canadian army. Surg Gynecol Obstet 79:225–239Google Scholar
  14. 14.
    Lozano-Calderon S, Blazar P, Zurakowski D, Lee SG, Ring D (2006) Diagnosis of scaphoid fracture displacement with radiography and computed tomography. J Bone Joint Surg Am 88(12):2695–2703.  https://doi.org/10.2106/JBJS.E.01211 CrossRefPubMedGoogle Scholar
  15. 15.
    Singh HP, Taub N, Dias JJ (2012) Management of displaced fractures of the waist of the scaphoid: meta-analyses of comparative studies. Injury 43(6):933–939.  https://doi.org/10.1016/j.injury.2012.02.012 CrossRefPubMedGoogle Scholar
  16. 16.
    Wallace PF (1963) Fractures of the carpal (wrist) navicular bone. Med Trial Tech Q 10:79–82PubMedGoogle Scholar
  17. 17.
    Cooney WP, Dobyns JH, Linscheid RL (1980) Fractures of the scaphoid: a rational approach to management. Clin Orthop Relat Res 149:90–97Google Scholar
  18. 18.
    Clay NR, Dias JJ, Costigan PS, Gregg PJ, Barton NJ (1991) Need the thumb be immobilised in scaphoid fractures? A randomised prospective trial. J Bone Joint Surg (Br) 73(5):828–832CrossRefGoogle Scholar
  19. 19.
    Thomaidis VT (1973) Elbow-wrist-thumb immobilisation in the treatment of fractures of the carpal scaphoid. Acta Orthop Scand 44(6):679–689CrossRefPubMedGoogle Scholar
  20. 20.
    Maudsley RH, Chen SC (1972) Screw fixation in the management of the fractured carpal scaphoid. J Bone Joint Surg (Br) 54(3):432–441CrossRefGoogle Scholar
  21. 21.
    Alho A, Kankaanpaa (1975) Management of fractured scaphoid bone. A prospective study of 100 fractures. Acta Orthop Scand 46(5):737–743CrossRefPubMedGoogle Scholar
  22. 22.
    Bongers KJ, Ponsen RJ (1980) Operative and nonoperative management of fractures of the carpal scaphoid: five years' experience. Neth J Surg 32(4):142–145PubMedGoogle Scholar
  23. 23.
    McQueen MM, Gelbke MK, Wakefield A, Will EM, Gaebler C (2008) Percutaneous screw fixation versus conservative treatment for fractures of the waist of the scaphoid: a prospective randomised study. J Bone Joint Surg (Br) 90(1):66–71.  https://doi.org/10.1302/0301-620X.90B1.19767 CrossRefGoogle Scholar

Copyright information

© SICOT aisbl 2018

Authors and Affiliations

  • Yadong Yu
    • 1
  • Haibin Cui
    • 1
  • Xiaoliang Yang
    • 1
  • Xiaofei Yu
    • 1
  • Yanbin Bai
    • 1
  1. 1.Hand SurgeryThe Third Hospital Of Hebei Medical UniversityShijiazhuangPeople’s Republic of China

Personalised recommendations