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Updated: May 30, 2026
C-arm-Free Simultaneous OLIF51 and Percutaneous Pedicle Screw Fixation in a Single Lateral Position
Published on: September 16, 2022
A comparison of 2 methods for scaphoid central screw placement from a volar approach
Geert Meermans1, Frederik Verstreken
1Department of Orthopaedics, Monica Hospital, Deurne, Belgium. geertmeermans@hotmail.com
Purpose:
We studied 2 methods used for screw placement through a volar approach for fixation of scaphoid fractures.
Methods:
We performed measurements on 20 computed tomography scans of unfractured scaphoids. A central virtual guidewire was computed in 10 scaphoids with the wrist in neutral or in extension and ulnar deviation. Second, we compared the central guidewire and a guidewire representing a volar approach to the scaphoid avoiding the trapezium.
Results:
The central guidewire passed through the trapezium in all cases with the wrist either in neutral or in extension and ulnar deviation. There was a statistically significant difference only in the sagittal plane. When the central guidewire was compared with a guidewire placed through a standard volar approach, the latter was more eccentric in the distal and waist portions.
Conclusions:
We showed that central placement throughout the scaphoid with a standard volar approach is not feasible without partially resecting, manipulating, or drilling through the trapezium.
Clinical Relevance:
Our data suggest that a volar transtrapezial approach can be an alternative for optimum central placement in volar percutaneous fixation of scaphoid fractures.
