Micro Screw Fixation for Small Proximal Pole Scaphoid Fractures with Distal Radius Bone Graft.

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Traumatology

Background:

• Proximal pole scaphoid fractures present surgical challenges due to small fragment size and limited blood supply.
• Achieving stable fixation and healing in these fractures is critical for patient outcomes.

Purpose of the Study:

• To evaluate the efficacy of osteosynthesis using a "micro" small diameter compression screw (≤2.8 mm) with distal radius bone graft for acute proximal pole scaphoid fractures.
• To demonstrate successful management of these challenging fractures with a minimally invasive approach.

Main Methods:

• A dorsal approach was used for fixation with a micro headless compression screw and distal radius bone graft.
• Included patients had proximal pole scaphoid fragments <20% of the total scaphoid area.
• Six patients were followed for an average of 44 months.

Main Results:

• Mean proximal pole fragment size was 14% (range, 9-18%).
• Average immobilization and time-to-union were 6 weeks.
• All patients achieved successful union with no avascular necrosis or loss of motion; final flexion/extension arc averaged 88°/87°.

Conclusions:

• Small diameter screws (≤2.8 mm) are effective for fixation of acute proximal pole scaphoid fractures (<20% fragment size).
• This surgical technique leads to good union rates and functional recovery.
• The method avoids complications like avascular necrosis and fragmentation.