Results of Herbert screw fixation in scaphoid fracture: A prospective study

Abstract

Summary Background Scaphoid fracture is a major cause of morbidity in patients with upper extremity injuries. Aims To assess clinical outcome and radiological union of scaphoid fracture after operative management following Herbert screw fixation in patient attending Sharda Hospital. Materials and methods This prospective study was carried out from December 2010 to December 2014. Out of 78 patients, 34 cases were of acute fractures and 44 cases of non-union. 34 cases of acute scaphoid fractures were treated with percutaneous Herbert screw fixation and 44 cases of non-union were treated with Herbert screw fixation with bone grafting. These study group patients were compared healing and complications with a matched control group of 78 scaphoid fractures. Serial radiographs were taken to assess radiographic union and functional outcome was assessed using Modified Mayo wrist score. All patients were followed for twelve months. Results Median time to union was longer for control group of scaphoid fractures compared with the study group of scaphoid fractures: 84 days (range, 70–104 days) versus 52 days (range, 40–76 days), respectively. Percutaneous Herbert screw fixation is an option to reliably diminish the incidence of nonunion and malunion with residual carpal instability that occur with cast immobilization in scaphoid fracture. The mean MMWS score was 92 (range 45–100). The results were excellent in 88.46% (69/78) and good in 11.53% (9/78) in study group patients. Conclusion The Herbert screw provides rigid internal fixation and allows earlier mobilization of the wrist.