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Dorsal Plating of Unstable Scaphoid Fractures and Nonunions

Bain, Gregory I. MBBS, FRACS, PhD, FA(Ortho)A*,†; Turow, Arthur MBBS; Phadnis, Joideep FRCS(Tr&Orth)

Techniques in Hand & Upper Extremity Surgery: September 2015 - Volume 19 - Issue 3 - p 95–100
doi: 10.1097/BTH.0000000000000087
Techniques
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Achieving stable fixation of displaced acute and chronic nonunited scaphoid fractures continues to be a challenge for the treating surgeon. The threaded compression screw has been the mainstay of treatment of these fractures for the last 3 decades; however, persistent nonunion after screw fixation has prompted development of new techniques. Recent results of volar buttress plating have been promising. We describe a novel technique of dorsal scaphoid plating. In contrast to volar plating, the dorsal plate is biomechanically more favorable as it utilizes the tension side of the scaphoid bone for dynamic compression. Dorsal scaphoid plating provides a more stable construct than the traditional Herbert screw and mitigates the need for vascular or corticocancellous bone grafting in most cases.

*Flinders University, Adelaide

Department of Orthopaedic Surgery, Flinders Medical Centre, Bedford Park, South Australia, Australia

Conflicts of Interest and Source of Funding:The authors report no conflicts of interest and no source of funding.

Address correspondence and reprint requests to Arthur Turow, MBBS, Department of Orthopaedic Surgery, Flinders Medical Centre, Flinders Drive, Bedford Park, South Australia 5042, Australia. E-mail: arthur.turow@health.sa.gov.au.

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