Percutaneous Cannulated Screw Fixation of Acute Scaphoid Waist Fracture

2002 ◽  
Vol 27 (1) ◽  
pp. 42-46 ◽  
Author(s):  
H. S. F. YIP ◽  
W. C. WU ◽  
R. Y. P. CHANG ◽  
T. Y. C. SO
Keyword(s):  
Prospective Study ◽  
Functional Recovery ◽  
Screw Fixation ◽  
Cannulated Screw ◽  
Union Rate ◽  
Scaphoid Fractures ◽  
Mean Time ◽  
Radiological Union

This prospective study assessed the outcome of percutaneous cannulated screw fixation in 49 of 60 acute scaphoid fractures. The union rate was 100% (mean time for radiological union at 12 weeks). There were no early or mid-term complications and all achieved an excellent functional recovery.

scholarly journals Scaphoid Fracture: Functional Outcome Following Fixation with Herbert Screw

2012 ◽  
Vol 9 (4) ◽  
pp. 267-273 ◽  
Author(s):  
N P Parajuli ◽  
D Shrestha ◽  
D Dhoju ◽  
R Shrestha ◽  
V Sharma
Keyword(s):  
Functional Outcome ◽  
Open Reduction ◽  
Screw Fixation ◽  
Scaphoid Fracture ◽  
Operative Management ◽  
University Hospital ◽  
Volar Approach ◽  
Herbert Screw ◽  
Scaphoid Fractures ◽  
Radiological Union

Background Most 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. Objectives To assess clinical outcome and radiological union of scaphoid fracture after operative management following Herbert screw fixation in patient attending Dhulikhel Hospital. Methods All 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. Results Out 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. Conclusion Fixation with Herbert screw for scaphoid fracture is an effective and convenient way of treatment with satisfactory functional outcome and less complication.DOI: http://dx.doi.org/10.3126/kumj.v9i4.6342 Kathmandu Univ Med J 2011;9(4):267-73

HERBERT SCREW FIXATION OF SCAPHOID FRACTURES

Hand Surgery ◽  
1999 ◽  
Vol 04 (01) ◽  
pp. 63-66 ◽  
Author(s):  
C. K. Low ◽  
B. T. Ang
Keyword(s):  
Screw Fixation ◽  
Type B ◽  
Scapholunate Dissociation ◽  
Herbert Screw ◽  
Scaphoid Fractures ◽  
Type D ◽  
Type C ◽  
Unstable Type ◽  
Radiological Union

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.

Percutaneous retrograde screw fixation of non-displaced fractures of the scaphoid waist: an antirotation wire may not be necessary

2009 ◽  
Vol 35 (3) ◽  
pp. 209-213 ◽  
Author(s):  
M. Soubeyrand ◽  
L. Thomsen ◽  
L. Doursounian ◽  
O. Gagey ◽  
G. Nourissat
Keyword(s):  
Computed Tomography ◽  
Screw Fixation ◽  
Cannulated Screw ◽  
Percutaneous Fixation ◽  
Percutaneous Screw Fixation ◽  
Scaphoid Fractures ◽  
Type Fracture

Some authors recommend using an antirotation wire when performing percutaneous screw fixation of acute non-displaced scaphoid waist fractures. The aim of this study of 21 cadaveric wrists was to assess the usefulness of such a wire in Herbert’s B2-type fractures. A B2-type fracture was created experimentally on each scaphoid. An antirotation wire was inserted in eight wrists. Retrograde percutaneous fixation using a double-threaded headless cannulated screw was performed on all wrists. Computed tomography was used to measure interfragmentary rotation. No interfragmentary rotation was noted in either group. Our study suggests that using an antirotation wire may be unnecessary when performing retrograde percutaneous screw fixation of isolated B2-type scaphoid fractures.

A comparison of long-term outcomes of translaminar facet screw fixation and pedicle screw fixation: a prospective study

2007 ◽  
Vol 7 (3) ◽  
pp. 287-292 ◽  
Author(s):  
Jayshree Tuli ◽  
Sagun Tuli ◽  
Marc E. Eichler ◽  
Eric J. Woodard
Keyword(s):  
Prospective Study ◽  
Pedicle Screw ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
Long Term Outcomes ◽  
Time To Surgery ◽  
Significant Difference ◽  
The Mean ◽  
Mean Time

Object In this paper, the authors compare the long-term outcomes of translaminar facet screw fixation (TFSF) and pedicle screw fixation (PSF) in the treatment of degenerative lumbosacral disease. Methods This prospective analytical study was performed to compare the long-term outcomes of TFSF and PSF for degenerative lumbosacral disease. Outcomes were defined as the need for reoperation for the development of a nonunion, end-fusion degeneration, or for explantation of hardware. Results A total of 77 patients were analyzed. Thirty-seven patients underwent PSF and 40 received TFSF. Twenty-three of the 77 patients required a reoperation: 13 (32.5%) of the 40 patients in the TFSF group and 10 (27%) of the 37 the patients in the PSF group. The overall mean time to reoperation (regardless of outcome) was 4.05 years. For patients in the TFSF group the mean time to reoperation was 2.94 years, whereas it was 4.35 years in the PSF group (p = 0.34). Nonunion was noted in seven of the 40 patients in the TFSF group and one of 37 in the PSF group. The mean time to surgery for nonunion for patients in the TFSF group was 3.46 years and for those in the PSF group it was 6.27 years (p = 0.04). Surgery for end-fusion degeneration was performed in two patients in the TFSF group and five in the PSF group (p = 0.43). Explantation of hardware was performed in two patients with TFSF and four patients with PSF. Multivariable analysis revealed a statistically significant difference in the time to surgery for nonunion between PSF and TFSF (p = 0.048), with a hazard ratio of 0.097 (95% confidence interval 0.01–0.98). Conclusions Findings from the current prospective study suggest that there is an increased risk of requirement for a reoperation for nonunion among TFSF cases compared with PSF cases.

PERCUTANEOUS CANNULATED SCREW FIXATION OF ACUTE SCAPHOID FRACTURES

Hand Surgery ◽  
2002 ◽  
Vol 07 (02) ◽  
pp. 271-278 ◽  
Author(s):  
W.-C. Wu
Keyword(s):  
Surgical Technique ◽  
Screw Fixation ◽  
Functional Results ◽  
Cannulated Screw ◽  
Fracture Union ◽  
Wrist Motion ◽  
Less Invasive ◽  
Scaphoid Fractures

Percutaneous cannulated screw fixation (PCSF) of acute scaphoid fractures has been shown to consistently produce good results. It is less invasive and avoids damage to the radiocarpal ligaments. The scar is good. The procedure could be performed under Bier's block anaesthesia. No cast is required after the operation and the range of wrist motion is regained early. Most recently reported series achieved more than 95% primary radiological fracture union. The functional results were good. The surgical technique of PCSF is described in detail and special tricks for difficult problems are highlighted.

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