Percutaneous fixation of scaphoid fractures with DTJ cannulated screws via a dorsal approach

Objective To summarize the experience of percutaneous fixation of scaphoid fractures with DTJ cannulated screws via a dorsal approach, and provide a reliable and efficient treatment method for scaphoid fractures. Methods 12 patients with scaphoid fractures were treated surgically by percutaneous fixation with DTJ cannulated screws via a dorsal approach, including 10 men and 2 women with an average age of 25 years. Among them, 3 cases were identified as type A2,5 as B2,2 as B3,and 2 as D1, according to the modified Herbert classification. Durations from injury to operation ranged from 1 to 12 days with an average of 3.5 days in acute cases, and were 76 days and 68 days in 2 D1 cases. The follow-up period were from 6 months to 20 months averaging with 14 months. Results All the patients achieved bone union at mean 8.5 weeks (range, 6.5 to 9.5 weeks) postoperatively. Pain relief was obtained in all cases except one mild wrist pain only after labor work. The grip strength and ROM (range of motion) returned to 86.4% (range, 82% to 93%) and 87.5% (range, 83% to 100%), compared with the healthy sides respectively. Only 1 patient had to change his job after operation due to the mild wrist pain. 6 patients returned to their previous working position at mean 5.5 weeks postoperatively, and 5 patients re-exercised at mean 4.5 months postoperatively. No operation complications such as infection occurred. Conclusion Percutaneous fixation with DTJ cannulated screws via a dorsal approach is a reliable and efficient treatment method for scaphoid fractures with mini-invasion, high bone union rate, and less complications. Key words: Scaphoid bone;  Fractures;  Bone screws