Book contents
- Frontmatter
- Dedication
- Contents
- List of contributors
- Preface
- Acknowledgments
- Part I Upper extremity
- Chapter 1
- Chapter 2
- Chapter 3
- Chapter 4
- Chapter 5
- Fractures of the wrist
- Chapter 6
- Part II Pelvis and acetabulum
- Part III Lower extremity
- Part IV Spine
- Part V Tendon injuries
- Part VI Compartments
- References
- Index
Fractures of the wrist
from Chapter 5
Published online by Cambridge University Press: 05 February 2015
- Frontmatter
- Dedication
- Contents
- List of contributors
- Preface
- Acknowledgments
- Part I Upper extremity
- Chapter 1
- Chapter 2
- Chapter 3
- Chapter 4
- Chapter 5
- Fractures of the wrist
- Chapter 6
- Part II Pelvis and acetabulum
- Part III Lower extremity
- Part IV Spine
- Part V Tendon injuries
- Part VI Compartments
- References
- Index
Summary
PERCUTANEOUS FIXATION OF SCAPHOID FRACTURES
Indications
Percutaneous fixation of scaphoid fractures is performed for:
(a) Undisplaced scaphoid fractures in active individuals or multiple injuries.
(b) Do not use this technique if fractures are displaced >1mm.
Pre-operative assessment
Clinical assessment
Assess vascularity of the hand, particularly the radial artery.
Assess for evidence of neural compromise - particularly in the median nerve distribution.
Assess the condition of the skin in the area of proposed incision.
Assess for tenderness in other areas around the wrist which may represent a second injury.
Radiological assessment
Anteroposterior (AP), lateral, 45? oblique and long-axis radiographs of the scaphoid.
Assess scaphoid length and look for evidence of fracture collapse (hump-back deformity, loss of carpal height).
Operative treatment
Anaesthesia
General or regional (axillary, supra- or infraclavicular block).
Intravenous dose of antibiotic as prophylaxis prior to inflation of tourniquet.
Tourniquet
Well-padded upper armcuff inflated to 250mmHg.
Plastic exclusion drape to prevent any soaking of padding by skin preparation.
Equipment
Percutaneousscrewsystemof choice with full selection of implants and screws.
Radiolucent hand table securely fastened to operating table.
Image intensifier or mini C-armfluoroscan.
Operating room set up
The armmust lie centrally on the hand table.
Surgeon is best seated at the distal end of the affected limb.
Image intensifier or mini C-armis brought in from the head of the table throughout the procedure.
- Type
- Chapter
- Information
- Practical Procedures in Orthopaedic Trauma Surgery , pp. 90 - 97Publisher: Cambridge University PressPrint publication year: 2006