Early Effect Of Arthroscopic-assisted Percutaneous Reduction And Internal Fixation With Bold Screw In Treatment Of Scaphoid Fracture

Objective: The purpose of this study was to evaluate the early effect ofArthroscopic-Assisted Percutaneous reduction and internal fixation withBold screw in treatment of scaphoid fracture.Methods: Twelve patients with scaphoid fracture were treated by wristArthroscopic-Assisted Percutaneous reduction and internal fixation withBold screw in our hospital from October2011to August2013,including4left hands and8right hands, acute fracture in11cases and neglected fracturein1case. Among them,11cases was identified as typeB2,1as B3,accordingto the modified Herbert classification. The rate of union, the time to unionand complication was recorded. The Mayo modification of the system wasused to evaluate the function of the wrist.Results: All patients were followed up for an average14.8±5.4months(6to24months).In the12cases, all the operational incisions obtainedprimary healing,11achieved bone union and one delayed union. The rate ofunion was91.7%.The mean time of union was10.4±1.7weeks. Ten patients suffered from no pain, one patient from mild pain，and one patient withdelayed union from moderate pain. The mean range of motions was65.0±11.5°extension (86.7%of the contralateral),62.9±9.4°flexion(84.03%of the contralateral), and the mean gripping strength was46.0±8.9kg (88.1%of the contralateral). According to the modified Mayostandard, the results were excellent in9cases, good in1case, fair in1caseand poor in1case, with the effective rate being83.3%.Varying degrees of soft-tissue and/or chondral injuries were diagnosedarthroscopically in all cases of this series. Four patients had partial tear ofthe radioscaphocapitate(RSC). Three patients suffered lunotriquetral(LT)ligament injuries.In four cases, arthroscopic examination revealed chondralinjuries. Two patients had partial rupture of the scapholunate interosseousligament without instability of Scapholunate joint. Additionally, thetriangular fibrocartilage complex (TFCC) was torn in one patient.Conclusion: The early clinical effect of Arthroscopic-AssistedPercutaneous reduction and internal fixation with Bold screw for scaphoidfracture is reliable, which has some advantage such as less trauma, assessingand managing soft-tissue lesions of the wrist，high union rate of the fracture,better wrist function recovery and minimal complications.