Screw fixation for scaphoid fracture: A comparision of volar and dorsal approach

The purpose of this study was to investigate whether the volar or dorsal approach for minimal incision scaphoid screw fixation allows for a good clinical result and for more central placement of the screw. We retrospectively reviewed twelve patients with a scaphoid fracture, who were treated with volar approach (6 patients), and treated with dorsal approach (6 patients). The displacement ratio of the screw in each group was compared to determine central screw placement and tendency of screw deviation. There was no difference between the two groups related to clinical results and central screw placement, suggesting that both groups have similar stiffness of screw fixation. Each approach had a definite tendency of screw deviation, which tend to locate volarly in volar approach and dorsally in dorsal approach at distal and proximal section (p=0.015). Appropriate surgical approach of the scaphoid fracture should be selected depending on location and direction of the fracture line.