Definition of scaphoid fractures:
In sports surgery, scaphoid fractures (the main wrist bone) are found in young athletes after violent sports injuries to the wrist. Arthroscopic sports surgery on the wrist greatly shortens postoperative recovery for athletes and immobilization, which will not exceed 15 days in recent scaphoid fractures.
Video of arthroscopic wrist surgery for a scaphoid fracture:
Diagnosis of scaphoid fractures:
This is a non-displaced fracture of the medial third of the scaphoid that can be confirmed by CT scan if in doubt.
Surgical treatment for scaphoid fractures:
This specialist surgery is performed on an outpatient basis under regional anaesthesia, with the patient comfortably positioned in the dorsal decubitus.
In non-displaced scaphoid fractures, surgery begins by fixing the fracture site with 2 K-wires under fluoroscopic monitoring.
Once the scaphoid fracture is fixed, arthroscopy through the radiocarpal portal can begin.
Joint bleeding and bubbles will be sucked out with a needle. The perifractural haematoma will be evacuated using a shaver.
The scaphoid fracture site can then be visualized perfectly . From the fracture site, it is possible to see the pins that have been left protruding into the joint deliberately to confirm their perfect positioning.‑
Arthroscopy also makes it possible to assess associated lesions to the wrist’s ligaments, at the scapholunate but also the TFCC.
Two buried fixation screws are then placed on the guide pins, achieving compression of the scaphoid fracture site.
The radiocarpal and mediocarpal arthroscopic views will confirm that the fixation screws do not interfere with the joint and that reduction and compression of the scaphoid fracture site are perfect.
The guide pins can then be removed.
The incisions are closed with Steri-strip.
This x-ray shows the post-operative result. The hardware will never need to be removed.
Recovery after scaphoid fracture surgery
For immobilization, a removable splint is kept for 10 days. Basic daily activities with the wrist can resume after 10 days, rugby after 2 to 3 months.