Carpus

Scaphoid, waist

Nonoperative treatment

Main indication: Non displaced waist or distal pole fracture

Skill:

Equipment:

Percutaneous screw fixation

Main indication: Undisplaced waist or distal pole fracture, patient request to avoid prolonged cast treatment

Skill:

Equipment:

Screw and K-wire fixation

Main indication: Displaced (> 1mm) mid-waist or distal pole fractures, proximal pole fractures, and fractures associated with perilunate injuries

Skill:

Equipment:

Scaphoid, proximal pole

Prograde screw fixation

Main indication: Virtually all proximal pole scaphoid fractures

Skill:

Equipment:

Perilunate, dissociation

ORIF of Lunotriquetral dissociation

Main indication: Acute LT ligament rupture in a higher demand active individual

Skill:

Equipment:

Ligament repair of scapholunate dissociations

Main indication: Acute SL ligament rupture in a higher demand active individual

Skill:

Equipment:

Lunate, dislocation

Open reduction, internal fixation (ORIF)

Main indication: Presence of a lunate dislocation

Skill:

Equipment:

Perilunate, fracture

Open reduction, internal fixation (ORIF)

Main indication: Trans scaphoid perilunate fracture dislocation

Skill:

Equipment:

Special considerations

*Skill
	Basic surgical experience, no specialized skills
	Some specialized surgical experience
	Highly experienced and skilled surgeon

*Equipment
	Basic equipment only
	Simple surgical and imaging resources
	Full specialized surgical and imaging resources

Scaphoid, waist

Nonoperative treatment

Percutaneous screw fixation

Screw and K-wire fixation

Scaphoid, proximal pole

Prograde screw fixation

Perilunate, dissociation

ORIF of Lunotriquetral dissociation

Ligament repair of scapholunate dissociations

Lunate, dislocation

Open reduction, internal fixation (ORIF)

Perilunate, fracture

Open reduction, internal fixation (ORIF)

Special considerations

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