Authors of section

Authors

Matej Kastelec, Renato Fricker, Fiesky Nuñez, Terry Axelrod

Executive Editor

Chris Colton

Open all credits

Anatomical structures for minimally invasive access to the scaphoid

When accessing the scaphoid percutaneously, the use of an image intensifier is essential.

Anatomical structures for minimally invasive access to the scaphoid

1. Confirming the fracture pattern

Before starting a percutaneous procedure, the scaphoid is screened using image intensification, to confirm that the fracture is suitable for this type of fixation.

Anatomical structures for minimally invasive access to the scaphoid

2. Hyperextension

Place a rolled towel or bolster under the wrist and hyperextend it.

Anatomical structures for minimally invasive access to the scaphoid

3. Mark the skin

It may be helpful to mark on the skin the position of the scaphoid, the palmar rim of the distal radius, and the level of the scaphotrapezial joint.

Anatomical structures for minimally invasive access to the scaphoid

4. Skin incision

A stab incision of 5 -10 mm is made distal to the scaphotrapezial joint.
Deepen through the subcutaneous tissues by blunt dissection. Then incise the capsule of the scaphotrapezial joint.
The distal pole of the scaphoid is now accessible for insertion of a K-wire.

Anatomical structures for minimally invasive access to the scaphoid