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Clinical Outcome of Percutaneous Fixation Without Arthroscopic Assistance for the Treatment of Acute Scaphoid Fractures
Ryo Okabayashi, MD1; Michio Sano, MD, PhD2; Takao Omura, MD, PhD3; Hiroaki Ogihara, MD4
1Iwata city Hospital, Iwata Cuity, Japan, 2Shizuoka City Shizuoka Hospital, Shizuoka City, Japan, 3Hamamatsu University School of Medicine, Hamamatsu, Japan, 4Hamamatsu Red Cross Hospita, Hamamatsu, Japan
Introduction: Percutaneous internal fixation for acute scaphoid fractures via dorsal approach (Slade technique) was first reported by Slade et al, in 2001 and has become of the most efficient treatment method. The purpose of this study was to retrospectively examine clinical outcome Slade technique without the assistance of arthroscopy for the treatment of acute scaphoid.
Method: Seventy eight acute scaphoid fractures operated by Slade technique without the assistance of arthroscopy between 2009 and 2014 were included in this study. The patients consisted of 65 males and 13 females with an average age of 32.6 years old (14 to 76). Scaphoid bone union rate, mean surgical time, post surgical complications, percentage range of motion (ROM) in comparison with the contralateral side and the presence of pain at the last follow up was investigated.
Result: Bone union rate was achieved in 98.6 percent of the patients. The mean surgical time was 27.4 minutes. Three cases required removal of the screw due to impingement in the radiocarpal joint. The percentage ROM in comparison with the contralateral side at the last follow up was 91.4 percent for dorsal flexion, and 91.8 percent for volar flexion. 76.3 percent of the patients had no pain at the final follow up.
Conclusion: Our study showed good bone union rate equivalent to previous reports, but there were three cases requiring screw removal due to impingement in the radiocarpal joint. Deeper attention is required for adequate screw insertion position ,direction, and the depth for Slade technique without the assistance of arthroscopy.
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