Jnl Wrist Surg 2020; 09(01): 034-038
DOI: 10.1055/s-0039-1698745
Scientific Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Antegrade Versus Retrograde Technique for Fixation of Scaphoid Waist Fractures: A Comparison of Screw Placement

1  Department of Orthopaedic Surgery, University Hospital Policlinico-Vittorio Emanuele, University of Catania, Italy
,
Kevin F. Lutsky
2  Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania
3  Division of Hand Surgery, Rothman Institute, Philadelphia, Pennsylvania
,
Christopher Jones
2  Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania
3  Division of Hand Surgery, Rothman Institute, Philadelphia, Pennsylvania
,
Erick Kazarian
4  Massachusetts General Hospital, Boston, Massachusetts
,
Daniel Fletcher
2  Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania
3  Division of Hand Surgery, Rothman Institute, Philadelphia, Pennsylvania
,
2  Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania
3  Division of Hand Surgery, Rothman Institute, Philadelphia, Pennsylvania
› Author Affiliations
Further Information

Publication History

27 March 2019

05 September 2019

Publication Date:
16 October 2019 (online)

Abstract

Background Scaphoid waist fractures are often treated using headless compression screws using dorsal or volar approaches.

Objectives The purpose of this study is to compare differences in screw position using a volar (retrograde) or dorsal (antegrade) approach.

Patients and Methods A total of 82 patients were retrospectively evaluated: 41 treated with a volar and 41 with a dorsal approach were selected. Postoperative radiographs were reviewed by three observers who rated screw location in the proximal pole, waist, and distal pole.

Results Thirty-four patients (83%) in the antegrade group had central screw placement in the waist of the scaphoid in posteroanterior and lateral planes compared with 14 (34.9%) in the retrograde group (p < 0.05). For the antegrade group, the screw was central in 217 of 246 zones (88.2%) compared with 127 of 246 (51.6%) in the retrograde group (p < 0.05).

Conclusions The dorsal antegrade approach appears to allow the surgeon to achieve central screw placement along all three scaphoid regions.

Level of Evidence This is Level III study.

Note

The work was performed at The Rothman Institute of Philadelphia.