The scaphoid is the most commonly fractured bone of the carpal row. Because of its precarious blood supply, scaphoid fractures are predisposed to avascular necrosis (AVN) and nonunion. This is especially true with fractures of the proximal pole. To decrease the risk of nonunion and AVN, surgical treatment of proximal pole scaphoid fractures is recommended, which facilitates fracture consolidation and long-term wrist function. We describe a 16-year-old adolescent boy who presented with a fracture of the proximal pole of the scaphoid, initially managed nonoperatively. Subsequent imaging findings revealed nonunion of the scaphoid bone. For treatment, a percutaneous fixation was chosen with a retrograde pin placement and antegrade screw placement. At 3 months postoperatively, the patient returned to competitive sports (ie, American football and basketball). Radiographs at 6 months postoperatively revealed promising healing. The described approach can provide an effective option for treating scaphoid fractures with nonunion.
Khalsa, Sirikrishna K.; Camille Aubin-Lemay; and Deana Mercer. "Technique of Proximal Pole Scaphoid Fracture Fixation Using a Retrograde Pin Placement but Antegrade Screw Placement: A Case Example." UNM Orthopaedic Research Journal 8, 1 (2019). https://digitalrepository.unm.edu/unm_jor/vol8/iss1/32