[Comparison between fixation with Herbert screws and Kirschner wires in the treatment of scaphoid pseudoarthrosis].
OBJECTIVE
To compare the treatment results of patients with scaphoid pseudoarthrosis, who were treated by autogenous cancellous bone grafting followed by fixation with Herbert screws or Kirschner wires.


METHODS
The study included 19 men (mean age 28 years, range 20 to 41 years) who were treated for scaphoid pseudoarthrosis and had a minimum follow-up of 12 months. Treatment was comprised of autogenous cancellous bone grafting and fixation with Herbert screws (n=10) or Kirschner wires (n=9). Fifteen right and four left hands were affected. The mean duration between the traumatic event and surgery was 20 months (range 3 to 72 months). Fractures were localized in the proximal pole (n=4, 21%), waist (n=13, 68%), and in the distal pole (n=2, 11%). The mean follow-up was 16 months for Herbert screws, and 21 months for Kirschner wires.


RESULTS
None of the patients exhibited a loss in range of motion of 10 degrees or more. The mean time to union was six months (range 3 to 20 months) with Herbert screws and eight months (range 4 to 22 months) with Kirschner wires. All patients had union with Kirschner wires, whereas non-union occurred in three patients with Herbert screws, two of whom had had proximal pole fractures. Radiologic outcome was significantly different between the two groups (p<0.01).


CONCLUSIONS
Because of good vascularity and union potential, scaphoid pseudoarthrosis can be successfully treated by an appropriate surgical technique using autogenous cancellous grafting independent of fixation materials.
Tuncay
Ibrahim
I
Department of Orthopedics and Traumatology (Ortopedi ve Travmatoloji Anabilim Dali), Research Hospital of Medicine Faculty of Karaelmas University, 67600 Zonguldak, Turkey. ibrahimtuncay@hotmail.com
Doğan
Ali
A
Alpaslan
Süleyman
S
D000328:Adult; D001863:Bone Screws; D016025:Bone Transplantation / Q000379:methods*; D001864:Bone Wires; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D005596:Fractures, Closed / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008297:Male; D011542:Pseudarthrosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D011859:Radiography; D016059:Range of Motion, Articular; D021361:Scaphoid Bone / Q000293:injuries* / Q000601:surgery; D016896:Treatment Outcome