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Radioscaphoid Impingement after Volar Plate Fixation and Bone Grafting of a Non-United Scaphoid Fracture.

Volar plate fixation (VPF) of scaphoid fractures has received increased attention over the past decade. The purported benefits over headless screw fixation are increased rigidity, better purchase of small fragments,… Click to show full abstract

Volar plate fixation (VPF) of scaphoid fractures has received increased attention over the past decade. The purported benefits over headless screw fixation are increased rigidity, better purchase of small fragments, the ability to prevent extrusion of bone graft, and to act as a buttress against excessive scaphoid flexion. We report a case of symptomatic radioscaphoid impingement presenting two years after successful VPF for a non-united scaphoid fracture. We performed an arthoscopic evaluation, synovectomy and chondroplasty, followed by open radial styloidectomy and implant removal. This article highlights the pertinent clinical features, relevant imaging, and key intra-operative findings. We have analyzed the factors that led to this complication and have highlighted several technical tips to minimize radiocarpal impingement and ongoing chondral damage.

Keywords: plate fixation; fixation; radioscaphoid impingement; non united; impingement; volar plate

Journal Title: The journal of hand surgery Asian-Pacific volume
Year Published: 2021

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