Background: Preliminary reports have indicated that selected
scaphoid nonunions—i.e., those that are well aligned and without
extensive sclerosis or bone resorption at the nonunion site—can be
treated effectively with internal fixation alone. We examined the feasibility
of percutaneous fixation in a series of such nonunions.
Methods: A consecutive series of fifteen patients with fibrous union
or nonunion of a carpal scaphoid fracture with minimal sclerosis or resorption
at the nonunion site were treated with rigid fixation alone (without bone
graft) with a headless compression screw inserted with a dorsal percutaneous
Results: Clinical examination, standard radiographs, and computed
tomography scans confirmed union in all patients at an average of fourteen
weeks. Nonunions treated less than six months after the injury healed faster
than those treated later (p < 0.02). According to the Mayo modified wrist
score, there were twelve excellent and three good results.
Conclusions: The results in our series were due to careful
examination and grading of the scaphoid nonunions preoperatively. The findings
in this small series support the observation in earlier reports that
percutaneous repair of selected scaphoid nonunions requires only rigid
fixation to achieve healing.