External fixator combined with cannulated screw and Kirschner wire fixation for the treatment of scaphoid fractures and transscaphoid perilunate dislocation

Objective To summarize the clinical outcomes of treating scaphoid fracture and transscaphoid perilunate dislocation using external fixator combined with cannulated screw and Kirschner wire fixation. Methods From December 2009 to December 2014, 18 cases of scaphoid fracture and transscaphoid perilunate dislocation were treated. The external fixator was applied to immobilize the wrist in 9 cases, while the scaphoid fracture was reduced and fixed with a cannulated screw. The capitate lunate joint was fixed temporarily with a Kirschner wire and the intercarpal ligaments were repaired. The other 9 cases were treated with the same internal fixation technique and intercarpal ligament repair, while the wrist joint was immobilized with a plaster cast postoperatively. Results All the patients were follow-up for 12 to 24 months and achieved wrist function recovery. There was no re-dislocation or avascular necrosis of the scaphoid or lunate. The Cooney scoring revealed excellent results in 4 cases, good results in 4 cases and fair results in 1 case in the external fixator group. In the plaster cast group, the results were excellent in 2 cases, good in 2 cases and fair in 5 cases. The difference was statistically significant (P 0.05). Conclusion The external fixator plays an important role in the treatment of scaphoid fracture and transscaphoid perilunate dislocation, as it facilitates early ligament repair and wrist joint function recovery. Key words: Scaphoid bone; External fixators; Scaphoid perilunate dislocation; Plaster external fixation