Fracturas del escafoides tratadas mediante osteosíntesis percutánea volar

Abstract

Purpose To analyze the functional and radiological results as well as the complications of carpal scaphoid fractures treated by means of volar percutaneous fixation. Materials and Methods A retrospective study was carried out of 41 patients with a mean follow-up of 15 months (range: 12–54). Fractures included in the study correspond to those classified as types B1 and B2 on Herbert's scale further to a detailed radiographic study for the carpal scaphoid. Fractures of the tubercle and the proximal pole were excluded from the study. Demographic data were collected on the mechanism of injury, postoperative complications and any associated lesions. Clinical and radiological evaluations were performed. The adapted DASH questionnaire was used for the functional assessment. Results Fracture healing occurred at 7-and-a-half weeks. All patients started using their hand in the first 2 weeks. Mean wrist range of motion one year into follow-up was 70° of extension and 65° of flexion. The final score on the adapted DASH scale was 44 points when there were no associated lesions and 80 when the fracture was associated with other injuries. The complications rate was 5.8% intraoperatively (2 instances of guide wire breakage) and 5.8% during follow-up. All cases went on to heal, except for one which developed pseudoarthrosis. OR time was of 20 min on average. Conclusions Volar percutaneous fixation is a simple, rapid technique characterized by low morbidity rates and scarce significant complications, which accelerates the patients’ functional recovery.