[Arthroscopically controlled minimal invasive screw fixation of scaphoid fractures. A pilot study]

We could not find any systematic studies about the value of arthroscopy in scaphoid fractures in the literature, and therefore undertook a pilot study of 20 scaphoid fractures which were treated arthroscopically by the Herbert-Whipple screw and were minimally invasive. We found very good radiological and clinical results in 17 patients and good results in 3 patients evaluated by the Wozasek and Moser score. For reduction of dislocated fractures we used distraction with 5 kg in the wine waiters position. In four cases we used additional K wires as joysticks. Arthroscopy is less valuable in reduction, however, it is important in verification of the compression force of the Herbert-Whipple screw and for diagnosis and therapy of lesions of the scapholunate ligament and TFC complex. We found seven SL instabilities, two lesions of the meniscus, and one Palmer 1B lesion of the TFC complex. From these results we conclude that arthroscopy should necessarily be done by minimally invasive osteosynthesis of scaphoid fractures to detect and treat discoligamentous injuries of the wrist.