Incidence of scaphotrapezial arthritis following volar percutaneous fixation of nondisplaced scaphoid waist fractures using a transtrapezial approach.
OBJECTIVE
To investigate whether volar percutaneous screw fixation of scaphoid waist fractures via a transtrapezial approach causes degenerative changes at the scaphotrapezial (ST) joint at short- to medium-term follow-up.


METHODS
A total of 34 patients were available for follow-up at a mean of 6.1 years (minimum follow-up, 3.7 y) after volar percutaneous fixation of acute scaphoid waist fractures via a transtrapezial approach. The clinical follow-up examination included assessment of pain using a visual analog scale, range of motion, grip strength, and key pinch strength. We obtained radiographs of both hands in 3 views. We staged degenerative changes at the ST joint according to the modified Eaton and Glickel classification.


RESULTS
The modified Mayo wrist score showed excellent clinical results using the described technique. One patient showed asymptomatic unilateral stage 2 osteoarthritic changes at the ST joint. We noted 6 screw protrusions, which required screw removal in 2 patients, in the early stages of use of the transtrapezial technique. One patient was treated surgically for a bone cyst.


CONCLUSIONS
Volar percutaneous screw fixation of nondisplaced scaphoid waist fractures using a transtrapezial approach does not lead to symptomatic scaphotrapezial osteoarthritis at short- to medium-term follow-up.


METHODS
Therapeutic IV.
Monica Hospital, Antwerp, and the Antwerp University Hospital, Edegem, Belgium.
Ghislain
G
Geurts
Roger
R
van Riet
Geert
G
Meermans
Frederik
F
Verstreken
D000293:Adolescent; D000328:Adult; D000368:Aged; D001863:Bone Screws; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000009:adverse effects* / Q000379:methods; D017102:Fracture Healing / Q000502:physiology; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D018737:Hand Strength; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D010147:Pain Measurement; D053401:Palmar Plate / Q000601:surgery; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D018570:Risk Assessment; D021361:Scaphoid Bone / Q000293:injuries* / Q000601:surgery; D013997:Time Factors; D051222:Trapezium Bone / Q000293:injuries / Q000601:surgery; D014954:Wrist Injuries / Q000000981:diagnostic imaging / Q000601:surgery; D055815:Young Adult