Scaphoid fractures

Summary

It is not clear whether the dorsal or volar approach is superior for screw fixation of scaphoid fractures, based on limited evidence from three small retrospective cohort studies with a total of 87 patients. Fracture union rates, functional outcomes, pain, and complications appear to be similar in patients treated with dorsal and volar approaches. Statistical significance was not consistent across studies, which may be a function of sample size and / or bias in some studies. To better understand the differences in outcomes between dorsal and volar approaches to screw fixation of scaphoid fractures, additional larger, methodologically rigorous trials are needed. A multi-center study may provide sufficient power to effectively study this question.