Volar versus Dorsal Percutaneous Screw Fixation for Acute Scaphoid Waist Fractures: a retrospective study

Abstract

Objectives: We aimed to compare the functional and radiological results of a volar or dorsal percutaneous approach for acute scaphoid waist fractures treated with headless cannulated compression screw. Methods: Acute fractures with less than 10 days of injury time, nondisplaced or minimally displaced fractures (<2 mm), and fractures at the scaphoid waist were included in the study. A single type of compression screw (3.5 mm, headless, cannulated, and full threaded) was used in all patients. Postoperatively, a short arm palmar splint with thumb support that held the wrist in a neutral position was applied to all patients for 2 weeks. Results: Nineteen patients were operated with the dorsal approach (group 1), and 17 patients were operated with the volar approach (group 2). There were 17 men and 2 women in group 1, and 16 men and 1 woman in group 2. The mean age of group 1 was 28.1 (range: 18-38) years, and the mean age of group 2 was 27.2 (18-39) years. Union was obtained and radiological consolidation was achieved in all patients in the study and there were no statistically significant differences between the groups in terms of wrist movements, grip and pinch force, or functional scores. Conclusions: We think that both volar and dorsal percutaneous approaches in acute scaphoid waist fractures are effective and reliable methods with similar clinical and functional results, and are thus a suitable alternative to each other.