Scaphoid screw placement under minimal radiation exposure.

Area of Science:

• Orthopedic surgery
• Radiology
• Anatomy

Background:

• Percutaneous scaphoid fixation offers advantages over ORIF and conservative methods.
• Current techniques require significant intraoperative X-ray use, leading to radiation exposure.

Purpose of the Study:

• To evaluate the feasibility and effectiveness of volar percutaneous scaphoid screw placement with reduced radiation exposure.

Main Methods:

• Utilized 20 cadaveric wrists with simulated non-displaced scaphoid fractures.
• Employed a percutaneous approach with a 2-mm Kirschner wire (K-wire) inserted blindly at a 45° angle.
• Assessed K-wire positioning using four X-rays and a rating scale.

Main Results:

• Radiographic views showed a median positioning score of 2 (moderate) along the scaphoid axis.
• The technique demonstrated moderate initial placement of the guide wire.

Conclusions:

• The 45° angled K-wire placement in percutaneous scaphoid fixation allows for initial moderate positioning.
• This method may facilitate faster optimization and reduce overall radiation exposure in scaphoid fracture treatment.