Percutaneous cannulated screw fixation of acute nondisplaced scaphoid waist fractures

Percutaneous screw fixation of acute, stable, scaphoid waist fractures has recently gained popularity secondary to the rapid fracture healing and decreased time off work/sports compared with cast immobilization. The historical background, pertinent anatomical considerations, and surgical technique of volar percutaneous cannulated screw fixation will be described. Additionally, the advantages of this technique over cast immobilization and open surgical stabilization methods will be reviewed. Although technically demanding, percutaneous cannulated screw fixation of scaphoid fractures provides rigid stabilization, faster union rates, and earlier return to work or sports. It is an attractive alternative to cast immobilization of acute, stable, scaphoid waist fracture in patients who understand the risks and benefits of this technique.