An innovative technique - Axial Loading and Compression Fixation (ALCF Technique) of scaphoid fracture by percutaneous K-wire

Abstract

Backgrounds Surgical fixation techniques used for the treatment of scaphoid fracture is still a topic of discussion among hand surgeons especially in terms of approach, implants and surgical techniques. We present an innovative technique of scaphoid fracture fixation by K-wire, which we accidentally encountered when the guide wire broke while doing a cannulated screw for the scaphoid. This technique of axial aligning, compression loading over a bent tip of K-wire across the fracture fragments of scaphoid is innovative. Materials The study included 16 patients operated for Scaphoid fracture between January-2017 to January-2020 by ALCF Technique. the patient age ranged from 18 to 69 years,M:F12:4, 13 fractures on dominant hand,10 fracture presented within 2 weeks, 7 were trans-scaphoid displaced fractures sustained in RTA, 3 proximal pole fractures sustained after a fall, 6 were delayed presentation more than 3 months. Method The technique used to pass a K wire from dorsally in ante grade fashion to align the fracture fragments along the anatomical axis of the scaphoid then bend the K wire at the proximal end so as to hook the proximal fragment. The distal end of the K wire is then applied manual traction load with gentle rotation to achieve compression at the fracture ends with rotational alignment on the distal fragment. The distal fragment is anvil on the proximal fragment by a K-wire binder before distally binding to achieve compression & relative stable fixation. Conclusion It is a simple, easy to reproduce, economic method to achieve reduction, compression using axial traction and union in all types of scaphoid fractures.