For fractures of the waist of the scaphoid where the bone has not shown progression towards healing, a percutaneous operation can be done. For this operation a guide-wire is passed across the fracture site using x-ray to guide it. A screw is then passed over the top of the guide wire. The screw is differential pitch, meaning it is able to provide compression at the fracture site and so the micro-movement at the fracture significantly reduces and the bone can heal.
This surgery is done as a day case procedure under general or regional anaesthetic. A very small cut is made on the front surface of the thumb muscles, and usually only paper stitches are required to close this. Afterwards the wrist is immobilised in a plaster cast for six weeks, and then movement exercises are started if the x-rays at six weeks show healing.
For more info see:-
Scaphoid fractures – Rupert Wharton
References:-
Davis TRC Ann R Coll Surg Engl 2013; 95: 171–176
doi 10.1308/003588413X13511609956895