title: [Percutaneous screw fixation of non- or minimally displaced scaphoid fractures].
abstract: OBJECTIVE
  Providing stability and reduction of the period of immobilisation of non- or minimally displaced scaphoid fractures using a minimally invasive technique.
  
  
  METHODS
  Scaphoid fractures of the types A2, B1 and B2 (Herbert's classification) with no or minimal displacement, along with a patient's request for early functional treatment.
  
  
  METHODS
  Relative contraindications: significant dislocation of the fracture, scaphoid cyst or a too proximal fracture, concomitant fractures of the wrist. Absolute contraindications: pseudoarthrosis, luxation fractures.
  
  
  METHODS
  Minimally invasive percutaneous screw fixation using a double threaded screw.
  
  
  METHODS
  Postoperative immobilisation in a plaster cast with a thumb inlay for 1-3 weeks until swelling and pain subside. Followed by active physiotherapeutic exercise, however no pressure on the hand for 6 weeks after surgery.
  
  
  RESULTS
  Seventy patients with a non- or a minimally displaced scaphoid fracture were treated between 2005 and 2011. We used percutaneous screw fixation as the therapy technique. A total of 57 patients (81%) presented for follow-up. Four patients (5.7%) had an unhealed fracture 6 months postsurgery confirmed. One patient needed revision surgery because of a screw that was too long. None of the patients had a postsurgical infection, haematoma or a complex regional pain syndrome. Smoking and putting pressure on the hand too early have been identified as possible risk factors for the unhealed fractures.
authors.affiliation: Klinik und Poliklinik für Unfall-, Hand-, Plastische und Wiederherstellungschirurgie, department of traumatology, Universitätsklinikum Würzburg, Julius Maximilians University of Wuerzburg, Oberdürrbacher Str. 6, 97070, Würzburg, Deutschland.
authors.forename: I S
authors.initials: IS
authors.lastname: Neshkova
authors.affiliation: Klinik und Poliklinik für Unfall-, Hand-, Plastische und Wiederherstellungschirurgie, department of traumatology, Universitätsklinikum Würzburg, Julius Maximilians University of Wuerzburg, Oberdürrbacher Str. 6, 97070, Würzburg, Deutschland.
authors.forename: R G
authors.initials: RG
authors.lastname: Jakubietz
authors.affiliation: Klinik und Poliklinik für Unfall-, Hand-, Plastische und Wiederherstellungschirurgie, department of traumatology, Universitätsklinikum Würzburg, Julius Maximilians University of Wuerzburg, Oberdürrbacher Str. 6, 97070, Würzburg, Deutschland.
authors.forename: D
authors.initials: D
authors.lastname: Kuk
authors.affiliation: Klinik und Poliklinik für Unfall-, Hand-, Plastische und Wiederherstellungschirurgie, department of traumatology, Universitätsklinikum Würzburg, Julius Maximilians University of Wuerzburg, Oberdürrbacher Str. 6, 97070, Würzburg, Deutschland.
authors.forename: M G
authors.initials: MG
authors.lastname: Jakubietz
authors.affiliation: Klinik und Poliklinik für Unfall-, Hand-, Plastische und Wiederherstellungschirurgie, department of traumatology, Universitätsklinikum Würzburg, Julius Maximilians University of Wuerzburg, Oberdürrbacher Str. 6, 97070, Würzburg, Deutschland.
authors.forename: R H
authors.initials: RH
authors.lastname: Meffert
authors.affiliation: Klinik und Poliklinik für Unfall-, Hand-, Plastische und Wiederherstellungschirurgie, department of traumatology, Universitätsklinikum Würzburg, Julius Maximilians University of Wuerzburg, Oberdürrbacher Str. 6, 97070, Würzburg, Deutschland. Schmidt_K@ukw.de.
authors.forename: K
authors.initials: K
authors.lastname: Schmidt
mesh_terms: D000328:Adult; D001863:Bone Screws; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D017759:Fractures, Malunited / Q000601:surgery*; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D021361:Scaphoid Bone / Q000293:injuries* / Q000601:surgery*; D016896:Treatment Outcome; D014954:Wrist Injuries / Q000601:surgery*
keywords: Hand injuries; Minimally invasive surgery; Scaphoid bone; Screw fixation; Surgical technique