ABSTRACT
Fractures of the scaphoid are common injuries, representing
60-70% of carpal fractures (1,2). Inadequate treatment of these
injuries can result in nonunion, osteonecrosis, carpal instability
patterns, all of which can lead to impaired function, and
arthrosis (3-5). Early results of cast immobilization of acute
fractures were quite favorable, reporting union rates of 88-100%
and good motion, grip strength, and function (6-9). However,
subsequent series have shown more discouraging
results, particularly with fractures displaced more than 1 mm
(10,11). The first factor in initiating appropriate treatment is the
proper and timely diagnosis of these fractures. Once diagnosed,
the fracture can be managed by closed, open, or percutaneous
methods. Internal fixation has the advantage of providing
compression and a stable construct which can allow early
range of motion (ROM) (12-17). However, an open approach
risks stripping of the critical blood supply to the scaphoid and
also division of important carpal ligaments, such as the radio-
scaphocapitate ligament (18). Percutaneous techniques have
since been developed, providing the benefits of ORIF with a
smaller incision, preservation of the carpal ligaments and
potentially fewer wound problems.
