ACUTE SCAPHOID FRACTURES: RESULTS OF PERCUTANEOUS AND OPEN SURGICAL TREATMENT IN 44 PATIENTS

Introduction: Scaphoid fractures account for about 75% of carpal fractures and mainly affect young adults. They are often missed and expose patients to nonunion and avascular necrosis. This study reports our department’s experience with their surgical treatment.
Materials and methods: We retrospectively reviewed 44 acute scaphoid fractures operated on between 2019 and 2024. Fractures were classified according to Schernberg. Treatment was percutaneous or open, with screw or Kirschner-wire fixation. Union was assessed on radiographs and functional outcome with the QuickDASH score.
Results: Mean age was 32 years (range 17–48), and 95% of patients were men. The mechanism was indirect in 95% of cases. Fractures involved the proximal pole in 22 cases, the upper waist in 16 cases and the tuberosity in 6 cases. Treatment was percutaneous in 36 cases (81.8%) and open in 8 cases (18.2%). Union was achieved in 39 cases (88.6%) after a mean of 6 weeks, at a mean follow-up of 24 months. Complications included 5 nonunions, 4 cases of avascular necrosis, 3 cases of osteoarthritis and 1 malunion.
Conclusion: Surgical fixation, especially percutaneous, provides a high union rate. Early diagnosis remains essential: any wrist injury should be considered a scaphoid fracture until proven otherwise.