title: Radiographic Parameters to Predict Union After Volar Percutaneous Fixation of Herbert Type B1 and B2 Scaphoid Fractures.
abstract: OBJECTIVE
  To study the angle of screw placement in relation to the scaphoid fracture plane and its effect on union after percutaneous fixation of scaphoid waist fractures.
  
  
  METHODS
  Twenty-four consecutive scaphoid waist fractures were retrospectively evaluated for the orientation of screws in relation to the fracture plane using a method in which the sum-of-smaller angles (SSA) in 3 different radiographs were used to correlate with time to fracture union.
  
  
  RESULTS
  All but one patient achieved union after percutaneous fixation of the scaphoid. Another patient required revision surgery within the study period for inadequate fixation. A shortened time to union was significantly correlated to larger SSA.
  
  
  CONCLUSIONS
  SSA may be a reasonable predictor of union after percutaneous fixation of scaphoid waist fracture. It can be reliably calculated using plain radiographs. An SSA of 190° or more correlated with union by 8 weeks postoperatively.
authors.affiliation: Kasr Al Ainy Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Mahmoud
authors.affiliation: Kasr Al Ainy Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Hegazy
authors.affiliation: Kasr Al Ainy Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Sherif Ahmed
authors.initials: SA
authors.lastname: Khaled
authors.affiliation: Beni Suef University Teaching Hospital, Beni Suef, Egypt.
authors.forename: Nasef Mohamed Nasef
authors.initials: NM
authors.lastname: Abdelatif
authors.affiliation: Department of Orthopaedics, Helwan University Hospital, Cairo, Egypt.
authors.forename: Walid
authors.initials: W
authors.lastname: Osman
authors.affiliation: Department of Orthopaedics, University of Rochester, Rochester, NY. Electronic address: openelfar@gmail.com.
authors.forename: John C
authors.initials: JC
authors.lastname: Elfar
mesh_terms: D001863:Bone Screws; D005593:Fracture Fixation, Internal; D017102:Fracture Healing; D050723:Fractures, Bone / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D053401:Palmar Plate; D011237:Predictive Value of Tests; D011859:Radiography; D012189:Retrospective Studies; D021361:Scaphoid Bone / Q000293:injuries*; D016896:Treatment Outcome
keywords: Scaphoid; fracture; percutaneous; union; waist
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