This is a case cohort study involving 8 patients who had stable scaphoid fractures and 16 patients with unstable scaphoid fractures, who underwent arthroscopic assisted reduction and screw fixation. The goal of the study was to document the chondral, osteochondral, and ligamentous injuries associated with scaphoid fractures. Fluoroscopy was used to confirm screw length and position.
Arthroscopic findings demonstrated partial scapholunate ligament tears in 4, partial lunotriquetral tears in 3, and TFCC tears in 3 patients. There were 2 additional patients who sustained combined scapholunate and partial palmar extrinsic ligament injuries. Chondral and osteochondral injuries were found in the 2 oldest patients in the series. The technique was successful with good or excellent results in 23 patients and 1 poor result.
The significance of this article is that unrecognized injuries to the wrist ligaments may occur when the scaphoid fractures. Although it is not entirely clear how many of the observed ligament findings were acute, some may occur at the time of trauma. Fortunately, of the 24 patients included in this study, none sustained complete ligamentous injuries to either the scapholunate or lunotriquetral ligaments.