Jae Kwang Kim; Jong Oh Kim; Seung Yup Lee; Nam Hoon Do

doi:10.12671/jkfs.2009.22.2.104

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Volar Percutaneous Cannulated Screw Fixation for Subacute Scaphoid Wasit Fracture: Jae Kwang Kim, M.D., Jong Oh Kim, M.D., Seung Yup Lee, M.D., Nam Hoon Do, M.D.; Journal of the Korean Fracture Society 2009;22(2):104-109.
DOI: https://doi.org/10.12671/jkfs.2009.22.2.104
Published online: April 30, 2009

Department of Orthopedic Surgery, School of Medicine, Ewha Womans University, Seoul, Korea.

Address reprint requests to: Jae Kwang Kim, M.D. Department of Orthopedic Surgery, Ewha Womans Mokdong Hospital, 911-1, Mok-6-dong, Yangcheon-gu, Seoul 158-710, Korea. Tel: 82-2-2650-2591, Fax: 82-2-2642-0349, kimjk@ewha.ac.kr

• Received: January 18, 2009 • Revised: February 12, 2009 • Accepted: March 30, 2009

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Abstract
REFERENCES

Abstract

Purpose
To report the surgical results of volar percutaneous cannulated compression screw fixation in subacute scaphoid fracture.
Materials and Methods
Between January 2004 and January 2007, eight consecutive patients with subacute scaphoid waist fracture, who sought medical attention between 4 weeks to 6 months after injury, were included in this study. All patients were male of an average age 29.2 years (range, 19 to 44). Mean duration of injury was 10.3±4.1 weeks. An acutrak cannulated screw (Acumed, Hillsboro, OR) was introduced volarly under image intensifier guidance in all patients. We performed radiological evaluation preoperatively and postoperatively. And we performed 12 months postoperatively using grip strength, range of motion (ROM) of the wrist, Mayo Modified Wrist Score (MMWS) and Disabilities of the Arm, Shoulder and the Hand (DASH) score for functional evaluation.
Results
Preoperative radiography showed minimal sclerosis line in three patients and a bone resorption around fracture sites in two patients. However, no patient had dorsal intercalated segment instability or more than 35 degrees of lateral intrascaphoid angle. Fractures united successfully at 11.6±2.1 weeks postoperatively without any requirement for a further procedure. At 12 months follow-up evaluations, ROM of the injured wrist was 93% of the uninjured wrist and grip strength of the injured wrist was 95% of the injured wrist. The mean MMWS was 93±6.6 and the mean DASH score was 4.8±1.2.
Conclusion
We believe that volar percutaneous cannulated screw fixation is a reliable method in case of subacute scaphoid waist fracture without scaphoid deformity or carpal instability.
Key words: Subacute scaphoid waist fracture, Volar, Percutaneous, Cannulated screw

REFERENCES

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Fig. 1

Subacute scaphoid waist fracture with minimal sclerosis.

(A) Anteroposterior radiograph shows a minimal sclerotic line around the fracture.

(B) Lateral intrascaphoid angle is 28 degrees in CT.

(C) Healing was achieved 10 weeks after volar percutaenous screw insertion.

Fig. 2

Subacute scaphoid waist fracture with cyst formation.

(A) Anteroposterior radiograph shows cyst formation with bone resorption at the fracture.

(B) CT shows cyst formation with bone resorption at the waist of scaphoid.

(C) Healing was achieved 14 weeks after volar percutaenous screw insertion.

Table 1

Preoperative data of patients group

Table 2

Data of patients group at 12 months follow up

DASH: Disabilities of the arm shoulder and hand, MMWS: Modified mayo wrist score, UW: Uninjured wrist, IW: Injured wrist, UH: Uninjured hand, IH: Injured hand.

Figure & Data

REFERENCES

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Surgical Outcome of Stable Scaphoid Nonunion without Bone Graft
Eun Sun Moon, Myung Sun Kim, Il Kyu Kong, Min Sun Choi
Journal of the Korean Fracture Society.2010; 23(1): 69. CrossRef

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Volar Percutaneous Cannulated Screw Fixation for Subacute Scaphoid Wasit Fracture

J Korean Fract Soc. 2009;22(2):104-109. Published online April 30, 2009

DOI: https://doi.org/10.12671/jkfs.2009.22.2.104

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Volar Percutaneous Cannulated Screw Fixation for Subacute Scaphoid Wasit Fracture

Fig. 1 Subacute scaphoid waist fracture with minimal sclerosis. (A) Anteroposterior radiograph shows a minimal sclerotic line around the fracture. (B) Lateral intrascaphoid angle is 28 degrees in CT. (C) Healing was achieved 10 weeks after volar percutaenous screw insertion.

Fig. 2 Subacute scaphoid waist fracture with cyst formation. (A) Anteroposterior radiograph shows cyst formation with bone resorption at the fracture. (B) CT shows cyst formation with bone resorption at the waist of scaphoid. (C) Healing was achieved 14 weeks after volar percutaenous screw insertion.

Fig. 1

Fig. 2

Volar Percutaneous Cannulated Screw Fixation for Subacute Scaphoid Wasit Fracture

Table 1

Preoperative data of patients group

Table 2

Data of patients group at 12 months follow up

DASH: Disabilities of the arm shoulder and hand, MMWS: Modified mayo wrist score, UW: Uninjured wrist, IW: Injured wrist, UH: Uninjured hand, IH: Injured hand.

Table 1 Preoperative data of patients group

Table 2 Data of patients group at 12 months follow up

DASH: Disabilities of the arm shoulder and hand, MMWS: Modified mayo wrist score, UW: Uninjured wrist, IW: Injured wrist, UH: Uninjured hand, IH: Injured hand.