174. PERCUTANEOUS SCREW FIXATION OF TYPE IIA AND IIB NONUNION OF THE SCAPHOID: 26 CASES

Abstract

Purpose of the study: Nonunion is a common complication of carpal scaphoid fractures. Incidence is 10% of all fracture types. No one technique has proven totally superior for the treatment of grade IIa and IIb nonunion of the carpal scaphoid (Alnot classification). In this study, we evaluated the contribution of percutaneous screw fixation for the treatment of these nonunions.

Material and methods: Our series included 26 patients with grade IIa (n=14) or IIb (n=12) nonunions. Outcome was assessed according to the clinical impact of the screw fixation and globally using the Quick DASH function score for the upper limb. Bone healing was assessed radiographically.

Results: Good outcome was good in 81% of the patients (93% for grade IIa and 68% for IIb) with the screw fixation, a healing rate similar to that obtained with classical techniques.

Discussion: Percutaneous screw fixation has the advantage of a mini-invasive approach and limits the risk of iatrogenic complications. It should thus be more widely used for the management of carpal scaphoid nonunions.