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Journal of Hand Surgery (British and European Volume)
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Articles

Imaging the Position of a Screw within the Scaphoid

A clinical, anatomical and radiological study

J. P. COMPSON
F. W. HEATLEY

From the Orthopaedic Academic Unit, St Thomas’s Hospital, London, UK

Correspondence: J. P. Compson, Orthopaedic Academic Unit, St Thomas’s Hospital, London, UK.

In an audit of 68 scaphoid fractures with delayed and non-union that had been internally fixed using the Herbert bone screw, it was found that 39 had a significant fault in screw position. Poor intra-operatrve imaging was a major contributing factor. An anatomical and radiological study was therefore performed to evaluate which views were necessary in order to be confident about screw position. We recommend a minimum of four views. To display the proximal pole, an ulnar deviated postero-anterior (PA) view and true lateral; and to display the distal pole, a semi-pronated and semi-supinated view.

Journal of Hand Surgery (British and European Volume), Vol. 18, No. 6, 716-724 (1993)
DOI: 10.1016/0266-7681(93)90230-D
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B. Vinnars, M. Pietreanu, A. Bodestedt, F. a. Ekenstam, and B. Gerdin
Nonoperative Compared with Operative Treatment of Acute Scaphoid Fractures. A Randomized Clinical Trial
J. Bone Joint Surg. Am., June 1, 2008; 90(6): 1176 - 1185.
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