Retrograde (Volar) Scaphoid Screw Insertion-A Quantitative Computed Tomographic Analysis

Screw fixation of the scaphoid through a volar approach is hindered by the trapezium, risks cutout through the concavity in the volar surface of the scaphoid, and is most likely to violate the dorsoulnar aspect of the radiocarpal articular surface of the scaphoid if the screw is too long. A relatively radial starting point facilitates placement of the screw tip in the center of the proximal pole and helps avoid the trapezium but drilling or partial excision of the trapezium often may be necessary for optimal screw placement.