| Because of the deep position of the scaphoid, scaphoid fracture fixation traditionally requires fairly wide surgical exposure. A variety of volar, dorsal and radial exposures have been described. Wide exposure has the disadvantages of creation of a wide zone of scar tissue as well as possibly disrupting existing circulation to the fracture site. This case illustrates a technique for limiting the dissection required for screw insertion from a dorsal approach. |
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| The problem: minimally displaced proximal pole scaphoid fracture three weeks post injury. Although this appears relatively innocuous, it actually has a significant chance of nonunion despite prolonged immobilization. |
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| Incision marking. The radial styloid is marked with a circle. A more proximal incision may better accomodate distal skin translation with wrist flexion. |
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| Exposure of the fracture line: |
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| Screw insertion site |
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| The patient was fitted with a removable splint, but was noncompliant, and actually had no immobilization after the first week. This is his motion two months after surgery: |
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| Xray before |
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| and two months postop: |
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| Xray before |
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| and two months postop: |
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percutaneous scaphoid fixation limited exposure scaphoid fracture |
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