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A Comparison of 2 Methods for Scaphoid Central Screw Placement From a Volar Approach.
MedLine Citation:
PMID:  21849237     Owner:  NLM     Status:  Publisher    
PURPOSE: We studied 2 methods used for screw placement through a volar approach for fixation of scaphoid fractures. METHODS: We performed measurements on 20 computed tomography scans of unfractured scaphoids. A central virtual guidewire was computed in 10 scaphoids with the wrist in neutral or in extension and ulnar deviation. Second, we compared the central guidewire and a guidewire representing a volar approach to the scaphoid avoiding the trapezium. RESULTS: The central guidewire passed through the trapezium in all cases with the wrist either in neutral or in extension and ulnar deviation. There was a statistically significant difference only in the sagittal plane. When the central guidewire was compared with a guidewire placed through a standard volar approach, the latter was more eccentric in the distal and waist portions. CONCLUSIONS: We showed that central placement throughout the scaphoid with a standard volar approach is not feasible without partially resecting, manipulating, or drilling through the trapezium. CLINICAL RELEVANCE: Our data suggest that a volar transtrapezial approach can be an alternative for optimum central placement in volar percutaneous fixation of scaphoid fractures.
Geert Meermans; Frederik Verstreken
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-8-15
Journal Detail:
Title:  The Journal of hand surgery     Volume:  -     ISSN:  1531-6564     ISO Abbreviation:  -     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-8-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7609631     Medline TA:  J Hand Surg Am     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
Department of Orthopaedics, Monica Hospital, Deurne, Belgium.
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