Scaphoid Fracture: Open Reduction Internal Fixation

Scaphoid fractures are very common in young, active individuals. Most fractures are nondisplaced and can be treated with cast immobilization; however, there is a strong demand to return to function as early as possible. Scaphoid fractures with displacement >1 mm can lead to nonunion and late carpal osteoarthritis. Displaced scaphoid fractures require anatomic reduction and rigid stabilization to optimize outcomes. Surgical fixation can be achieved from either the dorsal approach or the volar approach. The location of the fracture, the presence of comminution, the amount of displacement, and associated injuries will determine the best surgical approach for the patient. There has been a tremendous improvement in surgical instrumentation and implants that allows patients the ability to return to function expeditiously and reliably.