Screw Fixation in the Management of the Fractured Carpal Scaphoid

Maudsley, Roy H.; Chen, S. C.

doi:10.1302/0301-620x.54b3.432

Cited by 71 publications

(14 citation statements)

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“…In accordance with Maudsley & Chen (1972) we have begun to operate primarily on the fractures with severe dislocation. One might also consider an early operation in the case of 8 fracture with a small, relatively dense proximal fragment.…”

Section: Discussion a N D C O N C L U S I O N Smentioning

confidence: 99%

Management of Fractured Scaphoid Bone: A Prospective Study of 100 Fractures

Alho

Kankaanpää

1975

Acta Orthopaedica Scandinavica

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Section: Discussion a N D C O N C L U S I O N Smentioning

confidence: 99%

Management of Fractured Scaphoid Bone: A Prospective Study of 100 Fractures

Alho

Kankaanpää

1975

Acta Orthopaedica Scandinavica

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“…Open reduction and internal fixation of acute fracture of the scaphoid using a compression lag screw was recommended by McLaughlin and Maudsley and Chen to allow early mobilization of wrist. 16,17 Herbert and Fischer first described the technique in 1984, since then the Herbert screw has become widely accepted as a mode of treatment. 18 9,21 In our study we have operated four cases of A2 type fractures which healed uneventfully with good clinical results compared to two patients who was treated initially with cast treatment eventually was operated and showed good results.…”

Section: Same Activities 25mentioning

confidence: 99%

Scaphoid Fracture: Functional Outcome Following Fixation with Herbert Screw

Parajuli

Shrestha

Dhoju

et al. 2012

Kathmandu Univ. Med. J.

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BackgroundMost 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. ObjectivesTo assess clinical outcome and radiological union of scaphoid fracture after operative management following Herbert screw fixation in patient attending Dhulikhel Hospital. MethodsAll 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. ResultsOut 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. ConclusionFixation with Herbert screw for scaphoid fracture is an effective and convenient way of treatment with satisfactory functional outcome and less complication. KEY WORDSscaphoid fracture, Herbert screw, functional outcome scaphoid fracture or with delayed union have expanded from open surgical technique to percutaneous fixation technique that reliably expedite fracture healing and return to work/ sport relative to traditional cast treatment.Predicting successful scaphoid healing after a fracture can be difficult because reported union rates range between 10% and 50% with traditional cast treatment. 5,6 The most influential factors for nonunion includes displaced fractures, fractures with ligamentous injuries and proximal pole fractures. Long term studies confirm a 10% to 12%

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“…8 Whilst the standard bone grafting procedure for nonunion may result in union in up to 85% of cases, 9,10 immobilisation in plaster for 3 to 6 months is usually required, something which is not desirable for any synovial joint. 11 The combination of rigid internal fixation with bone grafting not only corrects the deformity 1 but also allows early functional recovery of the wrist as the use of plaster is avoided.…”

Section: Figmentioning

confidence: 99%

Herbert Screw Fixation of Scaphoid Fractures

Low

Ang

1999

Hand Surg.

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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.

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Screw Fixation in the Management of the Fractured Carpal Scaphoid

Cited by 71 publications

References 1 publication

Management of Fractured Scaphoid Bone: A Prospective Study of 100 Fractures

Management of Fractured Scaphoid Bone: A Prospective Study of 100 Fractures

Scaphoid Fracture: Functional Outcome Following Fixation with Herbert Screw

Herbert Screw Fixation of Scaphoid Fractures

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