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

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

1993 ◽  
Vol 18 (2) ◽  
pp. 219-224 ◽  
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.

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 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

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 Factors Associated with Scaphoid Nonunion following Early Open Reduction and Internal Fixation

2020 ◽  
Vol 09 (02) ◽  
pp. 141-149
Author(s):  
Pooja Prabhakar ◽  
Lauren Wessel ◽  
Joseph Nguyen ◽  
Jeffrey Stepan ◽  
Michelle Carlson ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Scaphoid Fracture ◽  
Receiver Operating Curve ◽  
Scaphoid Nonunion ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Fracture Location ◽  
Scaphoid Fractures ◽  
Time From Injury

Abstract Background Nonunion after open reduction and internal fixation (ORIF) of scaphoid fractures is reported in 5 to 30% of cases; however, predictors of nonunion are not clearly defined. Objective The purpose of this study is to determine fracture characteristics and surgical factors which may influence progression to nonunion after scaphoid fracture ORIF. Patients and Methods We performed a retrospective case–control study of scaphoid fractures treated by early ORIF between 2003 and 2017. Inclusion criteria were surgical fixation within 6 months from date of injury and postoperative CT with minimum clinical follow-up of 6 months to evaluate healing. Forty-eight patients were included in this study. Nonunion cases were matched by age, sex, and fracture location to patients who progressed to fracture union in the 1:2 ratio. Results This series of 48 patients matched 16 nonunion cases with 32 cases that progressed to union. Fracture location was proximal pole in 15% (7/48) and waist in 85% (41/48). Multivariate regression demonstrated that shorter length of time from injury to initial ORIF and smaller percent of proximal fracture fragment volume were significantly associated with scaphoid nonunion after ORIF (63 vs. 27 days and 34 vs. 40%, respectively). Receiver operating curve analysis revealed that fracture volume below 38% and time from injury to surgery greater than 31 days were associated with nonunion. Conclusion Increased likelihood for nonunion was found when the fracture was treated greater than 31 days from injury and when fracture volume was less than 38% of the entire scaphoid. Level of Evidence This is a Level III, therapeutic study.

Percutaneous Cannulated Screw Fixation of Acute Scaphoid Waist Fracture

2002 ◽  
Vol 27 (1) ◽  
pp. 42-46 ◽  
Author(s):  
H. S. F. YIP ◽  
W. C. WU ◽  
R. Y. P. CHANG ◽  
T. Y. C. SO
Keyword(s):  
Prospective Study ◽  
Functional Recovery ◽  
Screw Fixation ◽  
Cannulated Screw ◽  
Union Rate ◽  
Scaphoid Fractures ◽  
Mean Time ◽  
Radiological Union

This prospective study assessed the outcome of percutaneous cannulated screw fixation in 49 of 60 acute scaphoid fractures. The union rate was 100% (mean time for radiological union at 12 weeks). There were no early or mid-term complications and all achieved an excellent functional recovery.

Analysis of functional outcome of management of scaphoid waist fractures with herbert screw fixation

2021 ◽  
Vol 12 (2) ◽  
pp. 193
Author(s):  
T Sivabalan ◽  
V Thirunarayanan ◽  
S Cheralathan ◽  
M Ravi ◽  
SSiva Shankar
Keyword(s):  
Functional Outcome ◽  
Screw Fixation ◽  
Herbert Screw

scholarly journals Therapeutic Analysis of Herbert Screw Fixation for Capitellar Fractures via the Anterior Approach in Children

2021 ◽  
Author(s):  
Lingpeng Ju ◽  
Linjun Jiang ◽  
Yuan Zhang ◽  
Jun Wu ◽  
Ming Li ◽  
...  
Keyword(s):  
Performance Index ◽  
Open Reduction ◽  
Anterior Approach ◽  
Screw Fixation ◽  
Rating System ◽  
Bony Union ◽  
Imaging Data ◽  
Herbert Screw ◽  
Elbow Function

Abstract Objective: To analyse the efficacy of open reduction and Herbert screw fixation for coronal fractures of the capitellum via the anterior approach in children.Methods: We retrospectively analysed the clinical and imaging data of 15 children with capitellar fractures who were admitted to our hospital from May 2014 to May 2019. The fracture was reduced through the cubital crease incision via the anterior approach and was internally fixated with Herbert screws. A follow-up was conducted after the operation to examine the fracture healing and elbow function. The postoperative functional recovery of patients was evaluated with the Mayo Elbow Performance index (MEPI) and the Broberg-Morrey rating system.Results: Patients underwent surgery 3.7 days after injury on average. Intraoperative fracture reduction was satisfactory. No vascular injury or nerve injury occurred. Bony union occurred in an average of 6 weeks after the operation. All children completed 12- to 36-month follow-up. At the last follow-up, the Mayo Elbow Performance index was considered excellent in 12 patients and good in three patients. The Broberg-Morrey score was considered excellent in 12 patients, good in two patients, and fair in one patient. Conclusion: Open reduction and Herbert screw fixation via the anterior approach are an ideal surgical method for the treatment of coronal fractures of the capitellum in children.Levels of Evidence: Therapeutic, retrospective study-Level IV

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