IMAGING THE POSITION OF A SCREW WITHIN THE SCAPHOID - A CLINICAL, ANATOMICAL AND RADIOLOGICAL STUDY

In an audit of 68 scaphoid fractures with delayed and non-union that h ad been internally fixed using the Herbert bone screw, it was found th at 39 had a significant fault in screw position. Poor intra-operative imaging was a major contributing factor. An anatomical and radiologica l study was therefore performed to evaluate which views were necessary in order to be confident about screw position. We recommend a minimum of four views. To display the proximal pole, an ulnar deviated poster o-anterior (PA) view and true lateral; and to display the distal pole, a semi-pronated and semi-supinated view.