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J Hand Surg Am. 2011 Nov;36(11):1753-8. doi: 10.1016/j.jhsa.2011.08.031.

Incidence of scaphotrapezial arthritis following volar percutaneous fixation of nondisplaced scaphoid waist fractures using a transtrapezial approach.

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1
Monica Hospital, Antwerp, and the Antwerp University Hospital, Edegem, Belgium.

Abstract

PURPOSE:

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.

TYPE OF STUDY/LEVEL OF EVIDENCE:

Therapeutic IV.

PMID:
22036275
DOI:
10.1016/j.jhsa.2011.08.031
[Indexed for MEDLINE]
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