Treatment of the Scaphoid Fractures Using the Herbert's Screw.
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From 1986, we have treated 44 scaphoid fractures using a Herbert bone screw. Of them, 24 patients (25 scaphoid fractures) were reviewed clinically and radiographically. 21 patients were men and 3 were women. The average age was 28.9 years (range, 12 to 58 years). There were 5 acute unstable fractures (Herbert Type B), 8 delayed unions (Type C), 1 fibrous non-union (Type D1) and 11 sclerotic non-unions (Type D2). Bone grafting was carried out in 7 of 8 delayed unions and in all of 11 sclerotic non-unions. The average period of immobilization in a plaster was three weeks. The average post-operative follow-up period was 1 year and 6 months (range, 4 months to 4 years).The results of 25 fractures were evaluated according to Herbert's and Inoue's grading system. 13 were excellent, 9 good, 2 fair and 1 poor. Two fair cases and one poor case were sclerotic non-unions (Type D2). The ratio of bone union was 100% in Type B, C, D1, however, that was 73% in Type D2. We concluded that the period of immobilization should be elongated in sclerotic non-union (Type D2) and technical problem cases.
- 西日本整形・災害外科学会の論文
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