Scaphoid fractures treated by Herbert screw fixation

1988 ◽  
Vol 13 (4) ◽  
pp. 453-455 ◽  
Author(s):  
R MORAN ◽  
J CURTIN
2012 ◽  
Vol 9 (4) ◽  
pp. 267-273 ◽  
Author(s):  
N P Parajuli ◽  
D Shrestha ◽  
D Dhoju ◽  
R Shrestha ◽  
V Sharma

Background Most scaphoid fractures though heal uneventfully with cast treatment, immobilization with cast is associated with complication like wrist stiffness. Open reduction and fixation with Herbert Screw though technically demanding procedure can yield excellent results and prevents complication like nonunions and loss of wrist function. Objectives To assess clinical outcome and radiological union of scaphoid fracture after operative management following Herbert screw fixation in patient attending Dhulikhel Hospital. Methods All scaphoid fracture, treated from Feb 2007 till Feb 2011, were retrospectively studied in Dhulikhel Hospital, Kathmandu University Hospital. Fifteen patients with scaphoid fractures were treated with Herbert screw. Fourteen were males and one was female. Serial radiographs were taken to assess radiographic union and functional outcome was assessed using Modified Mayo wrist score. Results Out of 15 patients, 13 scaphoid had waist fractures and two had proximal pole factures. All scaphoid were treated with open reduction and Herbert screw fixation either by volar approach or by dorsal approach. All fractures maintained good alignment post operatively. Nine (60%) patients had excellent results with normal wrist range of motion, five (33.3%) patients had good results and one (6.7%) patient had poor outcome. In 14 (93.3%) patients good radiological union was seen at final follow up at six months time. Conclusion Fixation with Herbert screw for scaphoid fracture is an effective and convenient way of treatment with satisfactory functional outcome and less complication.DOI: http://dx.doi.org/10.3126/kumj.v9i4.6342 Kathmandu Univ Med J 2011;9(4):267-73


Hand Surgery ◽  
2003 ◽  
Vol 08 (02) ◽  
pp. 213-218 ◽  
Author(s):  
In-Ho Jeon ◽  
Chang-Wug Oh ◽  
Byung-Chul Park ◽  
Joo-Chul Ihn ◽  
Poong-Taek Kim

The purpose of this study is to document the percutaneous Herbert screw fixation technique with free-hand method to stabilise acute unstable scaphoid fractures and evaluated the clinical results. Thirteen patients with less than 14 day-old fractures were fixed by percutaneous Herbert screw and reviewed retrospectively for a minimum of 24 months (average, 37 months). All were men with an average age of 22 years. According to Herbert's classification, all fractures were classified as of the acute unstable (B2). Fracture union was achieved in all cases at a mean of 9.2 weeks (eight to 12 weeks). Return to work or school ranged from one day to three weeks according to their occupation. This percutaneous fixation technique using Herbert screw is a reliable and effective alternative for acute scaphoid fractures, which enables the patient to use the hand earlier with high satisfaction and minimum complication.


Hand Surgery ◽  
1999 ◽  
Vol 04 (01) ◽  
pp. 63-66 ◽  
Author(s):  
C. K. Low ◽  
B. T. Ang

Forty-four scaphoid fractures treated with open reduction and internal fixation using the Herbert screw were available for evaluation at an average follow-up period of 2.1 years and a range of 1 to 6 years. They were classified according to Herbert into 25 unstable (type B); 8 delayed unions (type C); and 11 nonunions (type D). Bone grafting was required in 22 cases. Sound radiological union was achieved in 42 cases at an average of 3.2 months. The two nonunions healed after revision grafting. Using the Mayo wrist score, excellent results were achieved in 14 cases; good in 22; fair in 4; and poor in 4. Poor results were associated with nonunion in two; untreated scapholunate dissociation in 1; and screw protrusion in 1.


2003 ◽  
Vol 28 (5) ◽  
pp. 496-499 ◽  
Author(s):  
N. J. S. KEHOE ◽  
R. G. HACKNEY ◽  
N. J. BARTON

Twenty patients treated with a Herbert screw for scaphoid fractures (acute or non-union) were reviewed and X-rayed 5–10 years later to assess whether there were degenerative changes in the scapho-trapezial joint due to insertion of the screw. Six had some irregularity in the lateral part of that joint, three of which followed backing-out of the screw. Two others were described as showing irregularity all round the scaphoid but, apart from these, no radiological abnormalities were seen in the central or ulnar part of the scapho-trapezial joint, or on the proximal tip of the scaphoid.


1988 ◽  
Vol 13 (4) ◽  
pp. 453-455
Author(s):  
R. MORAN ◽  
J. CURTIN

Forty-one scaphoid fractures had Herbert screw fixation. There were three acutely displace fractures (Type B), nine delayed unions (Type C), and 29 non-unions (Type D). All procedures were carried out by the senior author between December 1983 and May 1987. The average time from injury to surgery was 19 months. All Type D fractures were bone-grafted. Six of the 29 Type D fractures failed to unite radiologically following surgery. Incorrect screw placement was a factor in two cases. The average time from injury to surgery in three of the others was seven years. Radiological evidence of screw loosening was present within two months of mobilising these cases. We feel that Herbert screw fixation may not be adequate when dealing with longstanding scaphoid non-unions, and stronger fixation or prolonged cast immobilisation may be necessary.


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