Percutaneous Herbert screw fixation for fractures of the scaphoid: review of 30 cases.
BACKGROUND
The purpose of this study was to evaluate the results of percutaneous fixation of undisplaced or minimally displaced fractures of the scaphoid using the first generation Herbert screw in terms of union, functional results and scaphoid mobility.


METHODS
30 of the 50 patients operated on in our department between 1995 and 2000 were available for evaluation by an independent observer. Wrist mobility, grip strength and key pinch were measured. Scaphoid mobility was evaluated by measuring radioscaphoid angles in flexed and extended positions on dynamic X-rays.


RESULTS
The union rate was comparable to that achieved by non-operative management (90%). Resumption of professional activities was possible long before bony union because immobilization was short. Grip strength, wrist and scaphoid mobilities were comparable to the controlateral sides except for scaphoid flexion. Persistent symptoms were found in 30% of the patients despite union of their fracture.


CONCLUSIONS
Our results demonstrate that percutaneous stabilization of undisplaced or minimally displaced fractures of the scaphoid preserves the mobility of the wrist and minimally alters the normal dynamics of the carpus. The duration of work inability is short.
Brutus
J P
JP
Centre de chirurgie de la main, clinique du parc Léopold, 38 rue Froissart, 1040 Bruxelles, Belgium. jpbrutus@hotmail.com
Baeten
Y
Y
Chahidi
N
N
Kinnen
L
L
Moermans
J P
JP
Ledoux
P
P
D000328:Adult; D001863:Bone Screws; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D005596:Fractures, Closed / Q000601:surgery*; D018737:Hand Strength; D006801:Humans; D008297:Male; D016059:Range of Motion, Articular; D021361:Scaphoid Bone / Q000293:injuries* / Q000601:surgery; D016896:Treatment Outcome