MINIMAL INVASIVE PERCUTANEOUS HERBERT SCREW FIXATION IN ACUTE UNSTABLE SCAPHOID FRACTURE

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
Keyword(s):  
Screw Fixation ◽  
Scaphoid Fracture ◽  
Clinical Results ◽  
Minimal Invasive ◽  
Percutaneous Fixation ◽  
Fixation Technique ◽  
Fracture Union ◽  
Herbert Screw ◽  
Scaphoid Fractures ◽  
High Satisfaction

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.

scholarly journals Scaphoid Fracture: Functional Outcome Following Fixation with Herbert Screw

2012 ◽  
Vol 9 (4) ◽  
pp. 267-273 ◽  
Author(s):  
N P Parajuli ◽  
D Shrestha ◽  
D Dhoju ◽  
R Shrestha ◽  
V Sharma
Keyword(s):  
Functional Outcome ◽  
Open Reduction ◽  
Screw Fixation ◽  
Scaphoid Fracture ◽  
Operative Management ◽  
University Hospital ◽  
Volar Approach ◽  
Herbert Screw ◽  
Scaphoid Fractures ◽  
Radiological Union

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

scholarly journals A PROSPECTIVE STUDY TO ASSESS THE FUNCTIONAL OUTCOME FOLLOWING ORIF VS PERCUTANEOUS FIXATION IN SCAPHOID FRACTURE

2020 ◽  
pp. 1-3
Author(s):  
Ravi Mehrotra ◽  
Sanjeev Mahawar ◽  
Dhruv Lashkare ◽  
Raj * Jaiswal
Keyword(s):  
Prospective Study ◽  
Functional Outcome ◽  
Scaphoid Fracture ◽  
Percutaneous Technique ◽  
Percutaneous Fixation ◽  
Volar Approach ◽  
Herbert Screw ◽  
Early Return ◽  
The Mean ◽  
A Prospective Study

The study aimed to assess clinical, radiological as well as functional outcome in patients of scaphoid fracture following open reduction as compared to percutaneous xation with Herbert Screw. This study was conducted at Department of orthopedics, for 1 year on 30 patients of scaphoid fracture. Fractures were rst tried for percutaneous xation using volar approach, ORIF with volar approach was used when adequate reduction was not achieved. Patients were followed at 2 week interval till union. Clinical assessment at nal followup was performed using MMWS. The mean mean duration of presentation after injury of 19.9 days (3 to 162 days). The mean MMWS score was 93.8 (90-100) for percutaneous and 83.8 (70-95) for ORIF. Since fracture treated with percutaneous xation are associated with early union and early return to functional activity as compared to ORIF, Herbert screw for xation with percutaneous technique for scaphoid fracture must be encouraged for displaced or undisplaced fracture

scholarly journals Anatomic Locking Plate Fixation for Scaphoid Nonunion

2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Joshua Mirrer ◽  
Just Yeung ◽  
Anthony Sapienza
Keyword(s):  
Bone Grafting ◽  
Locking Plate ◽  
Screw Fixation ◽  
Plate Fixation ◽  
Scaphoid Fracture ◽  
Fracture Repair ◽  
Scaphoid Fractures ◽  
Severity Of Injury ◽  
Operative Fixation ◽  
Anatomic Locking Plate

Nonunion can occur relatively frequently after scaphoid fracture and appears to be associated with severity of injury. There have been a number of techniques described for bone grafting with or without screw fixation to facilitate fracture healing. However, even with operative fixation of scaphoid fractures with bone grafting nonunion or malunion rates of 5 to 10 percent are still reported. This is the first report of an anatomic locking plate for scaphoid fracture repair in a 25-year-old right hand dominant healthy male.

HERBERT SCREW FIXATION OF SCAPHOID FRACTURES

Hand Surgery ◽  
1999 ◽  
Vol 04 (01) ◽  
pp. 63-66 ◽  
Author(s):  
C. K. Low ◽  
B. T. Ang
Keyword(s):  
Screw Fixation ◽  
Type B ◽  
Scapholunate Dissociation ◽  
Herbert Screw ◽  
Scaphoid Fractures ◽  
Type D ◽  
Type C ◽  
Unstable Type ◽  
Radiological Union

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.

scholarly journals Combined Fractures of the Scaphoid and Distal Radius: Evaluation of Early Surgical Fixation (21 Patients with 22 Wrists)

2017 ◽  
Vol 07 (01) ◽  
pp. 011-17
Author(s):  
Tahir Sügün ◽  
Murat Kayalar ◽  
Yusuf Gürbüz
Keyword(s):  
Distal Radius ◽  
Screw Fixation ◽  
Functional Results ◽  
High Energy ◽  
Activity Level ◽  
Type B ◽  
Fixation Technique ◽  
Scaphoid Fractures ◽  
Surgical Fixation ◽  
The Mean

Introduction The purpose of this retrospective study, is to evaluate the clinical and functional results of early surgical fixation of the ipsilateral distal radius and scaphoid fractures in 22 of 21 patients. Patients and Methods Overall, 22 combined ipsilateral scaphoid, and distal radius fracture treatments between 2002 and 2015 were evaluated. The mean age was 34.9 (range: 19–82) years. One patient had bilateral injuries. In 17 patients the injury was due to a fall from a height, and in 4 patients due to a motorcycle accident. According to the AO classification, there were 2 type B and 20 type C fractures of the distal radius. The volar locking plate fixation technique was applied in 14 wrists, screw fixation technique in 1, external fixation combined with Kirschner wires (K-wire) stabilization technique was used in 3 wrists, and only K-wire pinning technique was used in 4 wrists. All scaphoid fractures were type B (21 type B2, 1 type B1) according to the Herbert–Fischer classification. K-wire fixation was applied in 2 and cannulated screw fixation was performed in 20 fractures. Clinical evaluation was performed with measuring the pinch power, grip power, and range of motions. Functional evaluation was performed using patient-rated wrist evaluation score (PRWE). Results The average follow-up period was 25 (range: 12–97) months. All radius and scaphoid fractures healed. The mean active wrist motions were found to be 45 degrees of flexion, 48.5 degrees of extension, 20 degrees of radial deviation, and 43 degrees ulnar deviation. Mean grip/pinch strengths were 31/8.5 kg. Mean PRWE score was 5.5 (range: 0–8.5). All patients returned to preoperative activity level and can do preinjury jobs. Conclusion Combined ipsilateral fractures of distal radius and scaphoid are complex and rare injuries due to high energy traumas. Stable early primary fracture fixation in these injuries can be expected with good functional results. Level of Evidence Level IV.

Percutaneous retrograde screw fixation of non-displaced fractures of the scaphoid waist: an antirotation wire may not be necessary

2009 ◽  
Vol 35 (3) ◽  
pp. 209-213 ◽  
Author(s):  
M. Soubeyrand ◽  
L. Thomsen ◽  
L. Doursounian ◽  
O. Gagey ◽  
G. Nourissat
Keyword(s):  
Computed Tomography ◽  
Screw Fixation ◽  
Cannulated Screw ◽  
Percutaneous Fixation ◽  
Percutaneous Screw Fixation ◽  
Scaphoid Fractures ◽  
Type Fracture

Some authors recommend using an antirotation wire when performing percutaneous screw fixation of acute non-displaced scaphoid waist fractures. The aim of this study of 21 cadaveric wrists was to assess the usefulness of such a wire in Herbert’s B2-type fractures. A B2-type fracture was created experimentally on each scaphoid. An antirotation wire was inserted in eight wrists. Retrograde percutaneous fixation using a double-threaded headless cannulated screw was performed on all wrists. Computed tomography was used to measure interfragmentary rotation. No interfragmentary rotation was noted in either group. Our study suggests that using an antirotation wire may be unnecessary when performing retrograde percutaneous screw fixation of isolated B2-type scaphoid fractures.

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