Fractures and non unions of the proximal pole of the carpal scaphoid bone. Internal fixation by a proximal to distal screw.

We report a new proximal to distal screw fixation technique for proximal pole fractures and non unions of the carpal scaphoid (type I of the Schernberg, Elzein and Gerard classification). Seven cases of non union with a live proximal polar fragment were operated from 1984 to 1986 with 4 excellent and 2 fair results and one failure. Three recent displaced fractures were also treated this way, with 3 excellent results. This useful technique is worth knowing and deserves a place in the treatment of scaphoid fractures, especially type I proximal pole fractures which represent a challenging problem, and are in no way comparable to other locations.