Micro Screw Fixation for Small Proximal Pole Scaphoid Fractures with Distal Radius Bone Graft

Journal of Wrist Surgery
Joseph J SchreiberMichelle G Carlson

Abstract

Background  Achieving adequate fixation and healing of small proximal pole acute scaphoid fractures can be surgically challenging due to both fragment size and tenuous vascularity. Purpose  The purpose of this study was to demonstrate that this injury can be managed successfully with osteosynthesis using a "micro" small diameter compression screw with distal radius bone graft with leading and trailing screw threads less than 2.8 mm. Patients and Methods  Patients with proximal pole scaphoid fragments comprising less than 20% of the entire scaphoid were included. Fixation was accomplished from a dorsal approach with a micro headless compression screw and distal radius bone graft. Six patients were included. Average follow-up was 44 months (range, 11-92). Results  Mean proximal pole fragment size was 14% (range, 9-18%) of the entire scaphoid. The mean immobilization time was 6 weeks, time-to-union of 6 weeks, and final flexion/extension arc of 88°/87°. All patients had a successful union, and no patient had deterioration in range of motion, avascular necrosis, or fragmentation of the proximal pole. Conclusion  Small diameter screws with a maximal thread diameter of ≤ 2.8 mm can be used to fix the union of proximal pole acute scap...Continue Reading

Citations

Mar 17, 2020·EFORT Open Reviews·Martin ClementsonNiels O B Thomsen
Feb 6, 2020·The Journal of Hand Surgery, European Volume·JungJun HongHo-Jung Kang
Sep 23, 2021·Journal of Plastic Surgery and Hand Surgery·Han Hong ChongHarvinder Pal Singh
Sep 28, 2021·Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association·Thanapong WaitayawinyuSunyarn Niempoog

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