A comparative study of Herbert screw internal fixation and plaster immobilization for the treatment of stable scaphoid fractures

Abstract

Objective To compare bone union and clinical results following Herbert screw internal fixation or plaster cast immobilization in the treatment of stable scaphoid fractures. Methods A retrospective analysis was conducted of 48 cases of scaphoid fractures with complete treatment and follow-up data. There were 26 patients whose fractures were treated with closed reduction and internal fixation with Herbert screw (group A), while 22 cases were treated conservatively with long-arm plaster cast immobilization (group B). Results Postoperative follow-up duration ranged from 12 to 36 months with an average of 23.7 months. Evaluation at the last follow-up using Mayo wrist function score revealed excellent results in 15 cases, good in 9 cases, and fair in 2 cases in group A, with an overall 92.3% excellent and good rate. In group B the results were rated as excellent in 9 cases, good in 8 cases, fair in 3 cases, and poor in 2 cases. The overall satisfactory rate was 77.3%. Wrist function was better in group A than in group B, the differences being statistically significant (P=0.018). Conclusion Treatment of stable scaphoid fractures with Herbert screws can achieve reliable fixation that allow early functional exercises. The fracture healing time is shorter and wrist function is better. Key words: Scaphoid bone; Fracture fixation, internal; Plaster external fixation