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Introduction: The purpose of this review is to describe complications that can occur with percutaneous scaphoid fixation and offer technical tips to minimize the chances of the problems occurring.

Methods: Our indications and technique for both dorsal and volar placement of headless compression scaphoid screws is reviewed as well as a review of the literature regarding technique pearls and pitfalls and described complications.

Results: The majority of technical errors and complications involved with the percutaneous treatment of non-displaced or reducible scaphoid fractures involve imprecise guidewire placement, erroneous screw length or poor patient/fracture selection.

Discussion: Significant improvements in technology such as mini-fluoroscopy, multiple versions of headless cannulated screws and increasing support in the literature to support minimally invasive surgery for acute non-displaced scaphoid fractures have all contributed to this procedure becoming more commonly performed. Resident surgeons are also exposed to this surgery more often in training and feel comfortable incorporating it into their staff practice. Scrutiny of fracture personality and exacting technique, however, are keys to successful percutaneous treatment of scaphoid fractures. If careful attention is not made to appropriate fracture type, optimal guidewire placement, selection of screw length and depth of screw seating, the risks of poor outcomes and complications increases. Review of the pertinent literature and experience gained in a practice that treats these injuries commonly, offers several technical tips to minimize intra-operative mistakes and improve outcomes for this challenging fracture type.