Fijación percutánea en fracturas de escafoides carpiano agudas no desplazadas.

Abstract

Introduction: The treatment of nondisplaced carpal scaphoid fractures is controversial. The objective is to present a series of patients treated surgically. Material and Methods: Data of 42 consecutive patients with Herbert type B1 and B2 fractures treated with percutaneous volar screw fixation were reviewed. Function was assessed using the quick-DASH (Disabilities of the Arm, Shoulder and Hand) questionnaire. Radiologically, the fracture union and the scapholunate (AEL) and capitolunar (ACL) angles were evaluated. Results: The mean follow-up time was 7.1 months (range, 5-12). The mean quick-DASH score at the final evaluation was 2.3 points (range, 0-27.3), which is consistent with an excellent outcome. Union was achieved in all cases, except one that presented nonunion, in a mean time of 5.7 weeks. The final mean AEL and ACL angles were satisfactory. There were no cases of scapholunate instability. All the patients, except one, returned to their previous activities in a mean time of 6.4 weeks. There was one case of pseudarthrosis, which required reintervention. Two patients reported discomfort from the screw after consolidation, with excellent outcomes after removed. Conclusion: Percutaneous screw fixation is an effective and safe method for nondisplaced or minimally displaced carpal scaphoid fractures, favoring rapid recovery and return to previous activities.