Herbert Screw Fixation of Scaphoid Fractures

Filan, S. L.; Herbert, Timothy J.

doi:10.1302/0301-620x.78b4.0780519

Cited by 295 publications

(223 citation statements)

References 56 publications

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“…Inoue and Shionoya [16] have shown a shorter time to union and an earlier return to manual labour when acute fixation is compared with conservative treatment. Early intervention is also supported by Filan and Herbert's operative findings [21]; in 82 acute fractures they noted that they were often in a worse position than suggested by radiographs and that there was soft-tissue interposition in 28 cases. Our results confirm previous findings that acute fixation of the scaphoid allows rapid return to full function and activity, including contact sports.…”

Section: Discussionmentioning

confidence: 82%

Percutaneous fixation of selected scaphoid fractures by dorsal approach

Naranje

Kotwal

Shamshery

et al. 2009

International Orthopaedics (SICOT)

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The aim of our study was to evaluate clinical, radiological and functional outcomes of selected cases of percutaneous fixation of scaphoid fractures via a dorsal approach. Percutaneous fixation by dorsal approach was done in 32 patients (mean age 32.2 years) involving both fresh and late scaphoid fracture presentations (mean 17 days). Fourteen cases of B1 type, ten cases of B2 and eight cases of C type (Herbert's classification) were treated. The patients were prospectively followed up clinically and radiologically for a minimum follow-up of 14 months (mean 16 months), and functional outcome and complications were assessed. All fractures united over an average of nine weeks. There was no avascular necrosis or screw cutout with preservation of wrist movement and grip strength. There were no injuries to any at risk anatomical structures. Percutaneous fixation of scaphoid fractures through dorsal approach gives good clinical and functional outcome in acute and chronic scaphoid fractures of B1, B2 and C types (Herbert's classification).

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Section: Discussionmentioning

confidence: 82%

Percutaneous fixation of selected scaphoid fractures by dorsal approach

Naranje

Kotwal

Shamshery

et al. 2009

International Orthopaedics (SICOT)

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“…Non-vascularized grafts, for example, IC-NBG, are widely applied as a standard technique, providing relatively large volumes and grafts that are relatively easy to harvest with good biomechanical properties. 18,27,28 As well, conventional bone grafts from the distal radius have been demonstrated to be an alternative to the IC-NBG in the past two decades. Mirly et al 29 approved the volume of non-vascularized bone grafts from the distal radius to be sufficient for most hand and wrist surgeries, even though the volume is less compared to grafts from the iliac crest.…”

Section: Discussionmentioning

confidence: 99%

Vascularized versus non-vascularized bone grafts in the treatment of scaphoid non-union

Hirche

Xiong

Heffinger

et al. 2017

J Orthop Surg (Hong Kong)

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Introduction: Conventional non-vascularized bone grafts as well as vascularized bone grafts are used to treat scaphoid non-union (SN). Due to limited available studies, the field of application using both grafts for SN still remains controversial. The aim of this study was to evaluate a treatment algorithm for the use of both vascularized versus non-vascularized bone grafts based on clinical outcomes and quality of life (QoL) to improve the level of evidence. Materials and Methods: Based on a retrospective cohort study, including 28 patients with vascularized and 45 patients with conventional bone grafts, functional parameters, radiological outcome, Mayo-wrist-score, and QoL by SF-36 were applied to statistically compare the outcome of these two techniques. Results: Time between last procedure or trauma and study group scaphoid reconstruction was almost double in the vascularized bone grafting group. Comparable union rates were achieved with vascularized as well as non-vascularized bone grafts. Significant differences were observed between both groups for grip strength and radial-ulnar active range of motion. Further functional outcomes, radiological outcomes as well as QoL were found similar for both techniques in patients with surgical union. Discussion and conclusions: In order to achieve comparable and appropriate treatment results, vascularized bone grafts are recommended for patients with delayed treatment, impaired scaphoid vascularity, and revision surgery. Even in preselected, complex cases, the results are comparable to conventional grafts, which are the basis for further patient education and approve the powerful role of surgical angiogenesis of vascularized bone grafts.

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“…[1][2][3] Surgical fixations for scaphoid nonunion have success rates of 70 to 90%. 4,5 The use of Russe inlay bone grafting or iliac crest bone grafting with screw fixation results in a success rate of 90%. 6 Non-union is more common in proximal pole fractures, because of compromised vascularity and conventional bone grafting may fail when it is completely avascular and there is evidence of necrotic bone and no bleeding.…”

Section: Introductionmentioning

confidence: 99%

“…6 Non-union is more common in proximal pole fractures, because of compromised vascularity and conventional bone grafting may fail when it is completely avascular and there is evidence of necrotic bone and no bleeding. 4,5,7,8 Vascularised bone grafting may introduce a source of angiogenic and osteogenic factors to the non-union site. 6,7 Vascularised pedicled bone grafts have been used in non-union of the anterior aspect of the wrist and forearm, the pronator quadratus and the scaphoid.…”

Section: Introductionmentioning

confidence: 99%

Outcome of vascularised muscle pedicle bone graft for scaphoid non-union

Charan

Verma

2018

Int J Res Orthop

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Background: The objective of the study was to assess the outcome of vascularised muscle pedicle bone graft for scaphoid non-union.Methods: 14 men and 6 women aged 18-45 (mean 25) years with non-union of scaphoid involving proximal pole (n=4), waist (n=14), distal pole (n=2) were randomized to undergo vascularised muscle pedicle bone graft with Herbert screw fixation. The mean duration of non-union was 10 months (range 4-14 months).Results: The mean follow up duration was 24 months. 17 of 20 achieved union. 12 of 20 achieved correction of both scapholunate and radiolunate angle. 5 of 20 did not achieve full correction of sacpholunate and radiolunate angle. 3 of 20 did not achieve union. 2 of these 3 were associated with proximal pole absorption. There was no hardware failure or any iatrogenic fracture during pedicle dissection. Conclusions: The use of vascularised bone graft has proved to be an effective method for treating scaphoid non-union, especially non-union with an avascular proximal pole and those that have failed to heal after previous procedure.

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Herbert Screw Fixation of Scaphoid Fractures

Cited by 295 publications

References 56 publications

Percutaneous fixation of selected scaphoid fractures by dorsal approach

Percutaneous fixation of selected scaphoid fractures by dorsal approach

Vascularized versus non-vascularized bone grafts in the treatment of scaphoid non-union

Outcome of vascularised muscle pedicle bone graft for scaphoid non-union

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