Indications

• Non-displaced scaphoid fractures in active individuals, or multiple injuries.

• Do not use this technique if fractures are displaced > 1 mm.

Preoperative assessment

Clinical assessment

• Assess vascularity of the hand, particularly the radial artery.

• Assess for evidence of neural compromise – particularly in the median nerve distribution.

• Assess the condition of the skin in the area of proposed incision.

• Assess for tenderness in other areas around the wrist, which may represent a second injury.

Radiological assessment

• Anteroposterior, lateral, 45-degree oblique and long-axis radiographs of the scaphoid.

• Assess scaphoid length and look for evidence of fracture collapse (humpback deformity, loss of carpal height).

Preoperative consent

• Obtain informed consent from the patient, including but not limited to risks, beneits, alternatives, complications and potential outcome.

Operative treatment

• The World Health Organization (WHO) Surgical Safety Checklist should be used in the operating room.

Anaesthesia

• General or regional (axillary, supra- or infraclavicular block).

• Preoperative prophylactic antibiotics as per local hospital/unit protocol.