Primary fixation of displaced carpal scaphoid fractures with the Herbert-Whipple screw

Abstract

We evaluated the results of primary open reduction and internal fixation with the Herbert-Whipple screw in acute displaced carpal scaphoid fractures. The study included 10 patients with acute displaced carpal scaphoid fractures and one patient with transscaphoid perilunate fracture dislocation. All the patients were males (mean age 34 years; range 23 to 44 years) and underwent primary open reduction and internal fixation with the Herbert-Whipple screw. The fractures were in the right and left wrists in nine and two patients, respectively. The mean follow-up period was 30 months (range 13 to 58 months). No early or late complications were encountered. All fractures healed in a mean of 11 weeks (range 9 to 15 weeks). All patients returned to their previous employment between four and 14 weeks postoperatively, being a mean of five weeks (range 4 to 7 weeks) for those employed in office-work and 10 weeks (range 9 to 14 weeks) for others. Primary open reduction and internal fixation with the Herbert-Whipple screw of acute displaced and unstable scaphoid fractures is an easy and reliable method leading to an uneventful union. Early operative intervention may avoid malunion, carpal instability, and radiocarpal osteoarthrosis that are often associated with closed treatment of these complex fractures.