The percutaneous antegrade scaphoid fracture fixation--a safe method?

INTRODUCTION

The object of this study was to assess the risk of injury to tendons, nerves and vessels in percutaneous antegrade scaphoid fracture fixation.

METHODS

Forty cadaveric forearms were used in this study. A guide wire for cannulated headless compression screws was inserted percutaneously in each scaphoid according to established surgical technique.

RESULTS

No nerve or vessel injuries were observed. Tendons however were injured in 5 out of the 40 specimens. This included the extensor pollicis longus tendon in two specimens, the extensor carpi radialis tendon in two specimens and the extensor digitorum tendon in one specimen.

CONCLUSIONS

Soft tissue injuries may be avoided by extending the skin incision and performing blunt dissection down to guide wire and screw entry point. In this manner, dorsal antegrade fixation of scaphoid fractures by using cannulated headless compression screws can be considered to be a safe and reliable technique for fixation of scaphoid fractures.