title: Comparison of dorsal and volar percutaneous screw fixation methods in acute Type B scaphoid fractures.
abstract: OBJECTIVE
  In this study, we aimed to compare the clinical and functional results of patients treated with dorsal or volar percutaneous screw fixation for acute scaphoid fractures.
  
  
  METHODS
  We retrospectively evaluated 27 wrists of 26 patients (24 males, 2 females; mean age: 33.1 years) who underwent dorsal or volar percutaneous screw fixation for acute scaphoid fractures between 2000 and 2009. The dorsal approach group contained 13 wrists and the volar approach group 14 wrists. Splint was removed and wrist exercises initiated on the 10th postoperative day. Pinch power, grip power and range of motion were evaluated using the contralateral wrist as controls. Functional evaluation was performed using the patient-rated wrist evaluation score (PRWE) and Mayo wrist scoring system.
  
  
  RESULTS
  According to the Herbert and Fisher's classification system there were 9 B2, 3 B3 and 1 B1 fractures in the dorsal approach group, and 12 B2 and 2 B1 fractures in the volar approach group. Fracture union was achieved in all patients. There was no significant difference between the two groups according to functional and clinical results (p>0.05). All patients returned to their jobs in an average of 4.2 weeks and there was no significant difference between the groups (p=0.437). Wrist flexion was significantly better in the control wrists in both groups (p=0.009). In one patient, the screw was removed due to ongoing pain and asymptomatic screw head displacement in the scaphotrapezoid joint was detected in another.
  
  
  CONCLUSIONS
  The surgical approach does not affect the clinical and functional outcomes in percutaneous screw fixation of Type B scaphoid fractures. Percutaneous fixation is a valuable treatment method for Type B scaphoid fractures as it enables early wrist motion and high patient satisfaction.
authors.affiliation: Hand Microsurgery Orthopaedics and Traumatology, EMOT, Hospital, İzmir, Turkey. ygurbuz@gmail.com
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Gürbüz
authors.forename: Murat
authors.initials: M
authors.lastname: Kayalar
authors.forename: Emin
authors.initials: E
authors.lastname: Bal
authors.forename: Tulgar
authors.initials: T
authors.lastname: Toros
authors.forename: Levent
authors.initials: L
authors.lastname: Küçük
authors.forename: Tahir Sadık
authors.initials: TS
authors.lastname: Sügün
mesh_terms: D000328:Adult; D001863:Bone Screws; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D056888:Patient Positioning / Q000379:methods; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology*; D012189:Retrospective Studies; D021361:Scaphoid Bone / Q000293:injuries* / Q000601:surgery; D016896:Treatment Outcome; D014954:Wrist Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D055815:Young Adult