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KMID : 0621520130180030111
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Journal of the Korean Society for Surgery of the Hand
2013 Volume.18 No. 3 p.111 ~ p.117
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Headless Autocompression Screw Fixation of Scaphoid Fractures Using Open Dorsal Approach
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Kang Ho-Jung
Won You-Gun
Kwon Ji-Won
Ko Il-Hyun
Choi Yun-Rak
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Abstract
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Purpose: We present the clinical and radiological results of open reduction andinternal fixation for scaphoid fracture with retrograde headless screw fixationvia dorsal approach.
Methods: This study carried out a survey targeting 15 patients who have a retrogradeheadless screw fixation on nonunion of scaphoid fracture without previousoperation, 2 patients who have a retrograde headless screw fixation onnonunion of scaphoid fracture with previous operation and 8 patients who havea trans-scaphoid perilunate dislocation. We figured out a mechanism of injury,and clinical symptom, radiologic findings. The surgery was done with open dorsalapproach which is retrograde headless screw fixation internally, with orwithout bone graft. We analyzed the result by Maudsley method, in terms ofbone union, duration for union, radiologic finding, clinical outcomes.
Results: After surgery, 22 of 25 patients had union result on fracture and other 3patients had nonunion result. It took 12 weeks to achieve bone union on average.Based on radiograhs, we had one case of partial avascular necrosis of proximalfragment without clinical symptoms. We had one case of each scaphoidnonunion without previous operation, with operation and trans-scaphoid perilunatedislocation had arthritic change and non-symptomatic nonunion result.In terms of clinical outcome, 22 patients showed satisfactory results and 3patients had slight limitation of range of motion.
Conclusion: Retrograde headless screw fixation with or without bone graft forthe treatment of scaphoid fracture is recommendable.
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KEYWORD
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Scaphoid fracture , Headless screw , Nonunion , Dorsal approach , Trans-scaphoid perilunate dislocation
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