title: Results of Herbert-screw fixation with bone-grafting for the treatment of nonunion of the scaphoid.
abstract: We examined twenty-one patients in whom an established nonunion of the scaphoid had been treated with Herbert-screw fixation with bone-grafting; our purpose was to determine the long-term morbidity of the procedure (at an average of forty-eight months; range, seventeen to fifty-five months). According to the modified scaphoid outcome scoring system, eighteen patients had a good or excellent result. No patient had failure of the hardware. Radial deviation was significantly decreased (an average of 17 degrees; 55 percent) compared with that of the contralateral wrist (p = 0.02). The other ranges of motion and the grip strength were also decreased, although the difference was not found to be significant with the numbers available. Three patients had a persistent nonunion, and two of them also had loosening of the hardware. Three patients had a tender hypertrophic scar. On the basis of our data, we concluded that Herbert-screw fixation with bone-grafting is effective for the treatment of nonunion of the scaphoid.
authors.affiliation: The Health Sciences Centre and St. Clare's Mercy Hospital, St. John's, Newfoundland, Canada.
authors.forename: B M
authors.initials: BM
authors.lastname: Rajagopalan
authors.forename: D S
authors.initials: DS
authors.lastname: Squire
authors.forename: L O
authors.initials: LO
authors.lastname: Samuels
mesh_terms: D000328:Adult; D001863:Bone Screws; D016025:Bone Transplantation; D002348:Carpal Bones / Q000293:injuries*; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology; D005599:Fractures, Ununited / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D009017:Morbidity; D016059:Range of Motion, Articular / Q000502:physiology; D013997:Time Factors; D016896:Treatment Outcome; D014955:Wrist Joint / Q000503:physiopathology