Scaphoid Fractures of the Wrist: Fixation With a Screw Animation

Scaphoid Fractures of the Wrist: Fixation With a Screw Animation

This surgical animation will demonstrate a scaphoid fracture being treated with a screw using a minimally invasive approach. In this demonstration, the screw shown is unique. It has no screw head. This design sits just below the surface of the bone, so it does not rub on nearby structures, which is important in bones with many joint surfaces, like the scaphoid. They are hollow-bodied screws that can be inserted over a wire with a very small incision. Lastly, they have threads that are placed at differing distances and have different widths at the top and bottom, which help provide optimal compression of the fracture.

Here is a left hand with a scaphoid fracture. A temporary wire will be inserted at the top of the scaphoid, aiming towards the base of the thumb. This will be done through a small incision in the skin and using x-rays. The fracture may require 2 temporary wires to hold it stable. The depth of the wire will be measured with a depth guide. The wire will then be minimally advanced through the far end of the bone.

A hollow drill bit will be put over the wire, and a hole will be drilled just into the far fragment of bone. The drill will be removed, and the proper-sized headless screw will be inserted into the path created by the drill. The fracture will be compressed together. The screw will sit just below both surfaces of the bone. The temporary wires will be removed. The small incision will be closed, and the surgery is complete.