Graft

Fractures with a defect: Add bone graft

In the case of fracture comminution, particularly with compromise of the palmar cortex, or a defect after removal of loose fragments, autogenous, cancellous bone graft, is necessary.

$Scaphoid displaced waist fractures – Scerw and K-wire fixation$

Harvest site

Harvest the graft material from the distal radius. A good and safe place is proximal and slightly radial to Lister’s tubercle.

$Scaphoid displaced waist fractures – Scerw and K-wire fixation$

Harvesting

Make a 2 cm longitudinal incision proximal to Lister’s tubercle. Retract the tendons of the second compartment radially, and the extensor pollicis longus (EPL) in an ulnar direction.

$Scaphoid displaced waist fractures – Scerw and K-wire fixation$

Use a chisel to cut three sides of a small square. Lift the dorsal radial cortex as a flap. After harvesting cancellous bone, replace the “lid”, and suture the periosteum and the skin incision.

$Scaphoid displaced waist fractures – Scerw and K-wire fixation$