This is a retrospective review of arthroscopically assisted reduction and percutaneous fixation of 15 acute scaphoid fractures. Patients were placed in finger traps with the traction device. The 3-4, 6R and midcarpal portals were established. The fracture site was visualized from the midcarpal portal and reduced. Reduction was performed using K-wire joy sticks and a compression device was applied using the Microvector Drill Guide System (Smith & Nephew). K-wires and screw position was verified under C-Arm guidance. Of note, the authors documented the presence of intraosseous ligament injuries.
All fractures united. Associated soft-tissue lesions were identified in 11 of 15 patients and two patients had scapholunate ligament injuries. It is interesting that the patients with partial scapholunate ligament injuries were treated with debridement alone whereas those patients with partial lunotriquetral ligament injuries were treated debridement and pinning of the LT ligament and the LT interval, respectively. One-third of cases also had TFCC tears and were repaired using and inside-out method. Percutanous scaphoid fixation can be safely performed using fluoroscopy or arthroscopy assistance. The procedure, however, does require a high level of technical skill and has a learning curve.