• Ghislain Geurts, Roger van Riet, Geert Meermans, and Frederik Verstreken.
• Monica Hospital, Antwerp, and the Antwerp University Hospital, Edegem, Belgium.
• J Hand Surg Am. 2011 Nov 1; 36 (11): 1753-8.

PurposeTo investigate whether volar percutaneous screw fixation of scaphoid waist fractures via a transtrapezial approach causes degenerative changes at the scaphotrapezial (ST) joint at short- to medium-term follow-up.MethodsA total of 34 patients were available for follow-up at a mean of 6.1 years (minimum follow-up, 3.7 y) after volar percutaneous fixation of acute scaphoid waist fractures via a transtrapezial approach. The clinical follow-up examination included assessment of pain using a visual analog scale, range of motion, grip strength, and key pinch strength. We obtained radiographs of both hands in 3 views. We staged degenerative changes at the ST joint according to the modified Eaton and Glickel classification.ResultsThe modified Mayo wrist score showed excellent clinical results using the described technique. One patient showed asymptomatic unilateral stage 2 osteoarthritic changes at the ST joint. We noted 6 screw protrusions, which required screw removal in 2 patients, in the early stages of use of the transtrapezial technique. One patient was treated surgically for a bone cyst.ConclusionsVolar percutaneous screw fixation of nondisplaced scaphoid waist fractures using a transtrapezial approach does not lead to symptomatic scaphotrapezial osteoarthritis at short- to medium-term follow-up.Type Of Study/Level Of EvidenceTherapeutic IV.Copyright © 2011 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

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