Results of arthroscopic reduction and percutaneous fixation for acute displaced scaphoid fractures.
OBJECTIVE
This study used percutaneous techniques augmented by simultaneous wrist arthroscopy to visualize the fracture and thus confirm the fracture alignment and reduction and also to assesses the concurrent associated ligament injuries.


METHODS
Retrospective study.


METHODS
Arthroscopy was used to help to reduce scaphoid fractures and assess soft-tissue injuries in 15 acute cases (13 male and 2 female patients). The fractures were treated by reduction under arthroscopic control and percutaneous fixation with the cannulated interosseous compression screw. Soft-tissue lesions were also treated at the same time using debridement, suture repair, or K-wire transfixation. The average age of the patients was 29.2 years (range, 19 to 48 years).


RESULTS
Two patients (13.3%) had scapholunate (SL) ligament injuries, and both exhibited partial tear of the SL ligament. Four patients (26.7%) suffered lunotriquetral (LT) ligament injuries and received ligament debridement, K-wire fixation of the LT joint, and splinting. Six patients (40%) had chondral fractures. Additionally, the triangular fibrocartilage complex (TFCC) was torn in 5 patients (33%). Finally, 5 patients (33%) suffered radioscaphocapitate ligament or long radiolunate ligament injuries. All fractures healed without malunion or nonunion and, at follow-up of 24 to 28 months, 11 patients had excellent results and 4 had good results based on Mayo Modified Wrist Scores.


CONCLUSIONS
We believe that arthroscopic reduction may be considered for scaphoid fractures because this approach can use a single procedure to achieve acceptable restoration of fractures as well as assessment and management of soft-tissue lesions.


METHODS
Level IV Therapeutic Study, case series with no, or historical, control group.
Shih
Jui-Tien
JT
Department of Orthopaedic Surgery, Armed Forces Taoyuan General Hospital, Long-Tan, Taoyuan, Taiwan. jui_tien_shih@hotmail.com
Lee
Hung-Maan
HM
Hou
Yao-Tung
YT
Tan
Chuan-Ming
CM
D000328:Adult; D001182:Arthroscopy / Q000379:methods; D016267:External Fixators; D051445:Fibrocartilage / Q000293:injuries / Q000601:surgery; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D008022:Ligaments / Q000293:injuries; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D021361:Scaphoid Bone / Q000293:injuries* / Q000601:surgery*