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The percutaneous antegrade scaphoid fracture fixation--a safe method?
Annelie Martina Weinberg1, Wolfgang Pichler, Stephan Grechenig
1Medical University of Graz, Department of Paediatric Surgery, Auenbruggerplatz 34, 8036 Graz, Austria.
Injury
|April 22, 2009
Summary
Percutaneous antegrade scaphoid fixation using cannulated headless compression screws risks tendon injury. Modifying the surgical approach by extending incisions and using blunt dissection can mitigate these risks, ensuring a safe fixation technique.
Area of Science:
- Orthopedic Surgery
- Anatomy
Background:
- Percutaneous antegrade scaphoid fixation is a common procedure.
- Assessing potential risks to surrounding neurovascular structures and tendons is crucial.
Purpose of the Study:
- To evaluate the risk of injury to tendons, nerves, and vessels during percutaneous antegrade scaphoid fracture fixation.
Main Methods:
- Forty cadaveric forearms were utilized for the study.
- Guide wires for cannulated headless compression screws were inserted percutaneously into the scaphoid following standard surgical techniques.
Main Results:
- No injuries to nerves or vessels were detected in any of the specimens.
- Tendons were injured in 5 out of 40 specimens, including the extensor pollicis longus (2), extensor carpi radialis (2), and extensor digitorum (1).
Conclusions:
- Soft tissue injuries during this procedure can be avoided.
- Extending the skin incision and employing blunt dissection to the guide wire and screw entry point enhances safety.
- Dorsal antegrade fixation of scaphoid fractures with cannulated headless compression screws is a safe and reliable technique when proper precautions are taken.
