When accessing the scaphoid percutaneously, the use of an image intensifier is essential.
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.
Place a rolled towel or bolster under the wrist and hyperextend it.
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.
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.