All surgical procedures for the scaphoid are technically demanding. Nonunion, however, is associated with predictable adverse consequences, and union is predicated on effective fracture immobilization. The arthroscopically assisted approach to scaphoid fractures provides the combined advantages of internal fracture fixation and minimally invasive surgical technique (Fig. 5). Patients are receptive to the approach, and the new fixation device has proven to be extremely effective in the first 5 years of clinical usage.