Complications in dorsal percutaneous cannulated screw fixation of nondisplaced scaphoid waist fractures

Purpose: With advances in tools and techniques, percutaneous screw fixation of nondisplaced fractures of the scaphoid waist has gained increasing popularity in recent years as an alternative to prolonged cast immobilization or open reduction and internal fixation. Many reports cite low complication rates, including no complications in some series. The purpose of this study was to evaluate the complications encountered with dorsal percutaneous cannulated screw fixation of nondisplaced scaphoid waist fractures. Methods: A retrospective chart review was performed for 24 patients who had surgery performed by a single surgeon over a 5-year period. All cases involved dorsal percutaneous cannulated screw fixation of nondisplaced (< 1 mm) fractures of the scaphoid waist. Complications were rated a priori as major or minor based on modifications of established criteria. Results: The overall complication rate was 29%; there were 21% (5/24) major complications and 8% (2/24) minor complications. Major complications consisted of 1 case of nonunion, 3 cases involving hardware problems, and 1 case of postoperative fracture of the proximal pole of the scaphoid. Minor complications included intraoperative equipment breakage-1 case involving a screw and 1 case involving a guide wire. Conclusions: Complications in dorsal percutaneous cannulated screw fixation of scaphoid fractures may be more common than previously reported.