The authors compare the functional outcome of 26 patients successfully treated by percutaneous osteosynthesis and 24 patients successfully treated by a short-arm thumb cast for the acute scaphoid fracture after a follow-up of at least 12 months. The patients treated by percutaneous osteosynthesis showed a significantly better range of wrist motion at the time of re-examination. Differences in persistent complaints and in grip strength compared to the uninjured wrist between both groups were statistically insignificant yet slightly in favour of the surgically treated patients. The higher suitability of percutaneous osteosynthesis is further supported by the significantly lower failure rate compared to conservative treatment. Based on these results, percutaneous osteosynthesis seemed to be the more favourable method of treatment of minimally and non-displaced scaphoid fractures than conservative treatment.

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The authors compare the functional outcome of 8 patients treated by distal scaphoid resection arthroplasty for scaphoid nonunion with symptomatic wrist arthritis before surgery and after a minimum follow-up of 6 months. There was a significantly better range of radial deviation and grip strength at the time of re-examination. Significantly fewer patients complained of resting pain. By contrast the change of radiolunate angle measured before the surgery and at the time of re-examination was statistically insignificant. Our preliminary results show that distal scaphoid resection arthroplasty seems to be a useful treatment method of scaphoid nonunion with symptomatic wrist arthritis.

Aims.To compare the functional results and complications associated with palmar percutaneous and dorsal limited approaches in the surgical treatment of nondisplaced or minimally displaced scaphoid fractures type B2. Methods. A total of 76 patients with acute nondisplaced or minimally displaced type B2 scaphoid fractures were included in a prospective randomised study. The assignment patients to groups according to type of operative approach was based on systematic sampling. Clinical follow-up, X-ray or CT imaging were performed at four, eight and twelve weeks and one year after the surgery. Patient satisfaction and the results of DASH form were evaluated as well. The differences were statistically tested. Results. We found significantly better flexion and grip strength in the group of palmar percutaneous aprroach during the follow-up examination at eight weeks after the surgery. Significantly better flexion of the same group persisted at twelve-week follow-up examination. No differences in results or complications were statistically significant up to one year follow up. Conclusions. We found no advantage to the palmar percutaneous approach in the treatment of nondisplaced and minimally displaced scaphoid fractures type B2 compared to dorsal limited approach.

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