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Journal of the Korean Society for Surgery of the Hand 2008;13(1):37-42.
Published online March 1, 2008.
Volar and Dorsal Percutaneous Screw Fixation for the Treatment of Acute Scaphoid Waist Fracture
Sung Hun Kim, Sun Hong Kim, Byung Hak Oh, Woo Suk Lee, Youn Moo Heo
급성 주상골 요부 골절에 사용된 장측과 배측 경피적 나사 고정의 비교
김성훈, 김선홍, 오병학, 이우석, 허윤무
Percutaneous Acutrak screw fixation for the treatment of acute scaphoid waist fracture can be performed with either a volar or dorsal approach. The purpose of this study was to analyze radiologically whether the volar or dorsal screw fixation allows for more central placement of screw and compare the clinical results between two groups. Materials and Methods: 25 patients with acute scaphoid waist fractures who were surgically treated with percutaneous Acutrak screw fixation were enrolled. 10 patients underwent volar approach and 15 patients underwent dorsal approach. On postoperative radiograph, displacement of the screw from the center of the scaphoid were analyzed at proximal, mid-waist and distal portion of the scaphoid. For the clinical result, duration of union, pain, work status, range of motion and grip strength were measured. Displacement ratio and clinical results were compared between two groups. Results: Dorsally inserted screws were located more centrally than volarly inserted screws but the difference was statistically significant only at the distal portion of scaphoid. The duration of union in patients with volarly inserted screws was 8.2 weeks and that with dorsally inserted screw was 7.9 weeks, but the difference was not statistically significant. There were no difference in clinical results between two groups and showed excellent or good results except one. Conclusion: The dorsal approach of percutaneous screw fixation for scaphoid waist fractures allows for a more central placement in the distal pole, but the clinical results was good irrespective of insertion methods.

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