Authors of section

Authors

Matej Kastelec, Renato Fricker, Fiesky Nuñez, Terry Axelrod

Executive Editor

Chris Colton

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Graft

1. 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