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Objective: To review the advances in diagnosis and treatment of acute scaphoid fractures. Methods: The characteristic, classification, diagnosis, and treatment of acute scaphoid fractures were reviewed and summarized. Results: As one of the common fracture in hand, scaphoid fractures are generally classified as either undisplaced and stable or displaced and unstable. CT and MRI has best diagnostic specificity and sensitivity respectively. Most undisplaced and stable fractures can be treated successfully by plaster immobilization, whereas the displaced and unstable fractures have great prognosis after open reduction and internal fixation. Conclusion: Acute scaphoid fractures should be diagnosed and treated at an early stage, and choose the appropriate treatment according to the location and stability of the fracture.
RESUMO
PURPOSE: The purpose of this study was to investigate the efficasy of dorsal percutaneous Acutrak screw fixation for acute stable or unstable scaphoid fractures. MATERIALS AND METHODS: We assessed 7 cases of acute scaphoid fracture from January 2001 to Febrary 2002, 5 cases were of acute stable fracture (Herbert type A2) and 2 cases were of unstable minimal displaced fracture (Herbert type B2). All were treated by dorsal percutaneous Acutrak screw fixation. The postoperative management protocol involved removing the splint at postoperative 1 week, this was followed by active and strengthening exercise. Patients returned to work at a postoperative 2 weeks, and a follow-up study 7cases from 12 to 20 months (average 15.8 months). RESULTS: According to tenderness at the anatomical snuff box, pain during range of motion of the wrist joint and the Maudsley scale, 6cases (Herbert type A2: 5 case, Herbert type B2: 1 case) were excellent and one case (Herbert type B2) was good. CONCLUSION: Dorsal percutaneous Acutrak screw fixation is useful method for acute stable or minimal displaced scaphoid waist fractures, because it reduces complications due to prolonged cast immobilization.