Symptomatic non-union of the carpal scaphoid: Matti-Russe bone grafting versus Herbert screw fixation

The results of treatment in 50 consecutive patients with established non-union of the scaphoid are presented. All patients were treated under the care of a single consultant, for the same indications. Russe bone graft is compared with wedge bone graft plus Herbert screw fixation, in terms of union and function. Overall, a higher success rate was obtained by wedge graft plus Herbert screw, and a significantly better range of movement. However, Russe bone graft appears equally satisfactory for fibrous non-union.

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Non-Union of the Scaphoid: Russe Graft vs Herbert Screw

Journal of Hand Surgery (European Volume) ◽

10.1016/0266-7681(93)90078-t ◽

1993 ◽

Vol 18 (3) ◽

pp. 408-409

Author(s):

C. D. Warren-Smith ◽

N. J. Barton

Keyword(s):

Bone Graft ◽

Success Rate ◽

Screw Fixation ◽

Range Of Movement ◽

Non Union ◽

Herbert Screw ◽

Results Of Treatment ◽

And Function

The results of treatment in 50 consecutive patients with established non-union of the scaphoid are presented. All patients were treated under the care of a single consultant, for the same indications. Russe bone graft is compared with wedge bone graft plus Herbert screw fixation, in terms of union and function. Overall, a higher success rate was obtained by wedge graft plus Herbert screw, and a significantly better range of movement. However, Russe bone graft appears equally satisfactory for fibrous non-union.

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Scaphoid Non-Union: Factors Affecting the Functional Outcome of Open Reduction and Wedge Grafting with Herbert Screw Fixation

Journal of Hand Surgery (European Volume) ◽

10.1016/0266-7681(93)90114-u ◽

1993 ◽

Vol 18 (2) ◽

pp. 219-224 ◽

Cited By ~ 63

Author(s):

R. NAKAMURA ◽

E. HORII ◽

K. WATANABE ◽

K. TSUNODA ◽

T. MIURA

Keyword(s):

Surgical Treatment ◽

Functional Outcome ◽

Open Reduction ◽

Screw Fixation ◽

Functional Results ◽

Bony Union ◽

Proximal Fragment ◽

Factors Affecting ◽

Non Union ◽

Herbert Screw

50 patients with scaphoid non-union were treated by open reduction, anterior wedge bone grafting and internal fixation using the Herbert screw. Intra-operative image intensiner control enabled us to insert the screw into the scaphoid accurately. An excellent or good functional outcome was less likely when more than 5 years had elapsed since injury, the non-union was in the proximal third, when sclerosis of the proximal fragment was present, and when reduction of carpal and scaphoid deformity was unsatisfactory. These four factors are believed to be the primary determinants affecting the functional results of the surgical treatment of scaphoid non-union, even when bony union is achieved.

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