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Acute percutaneous scaphoid fixation using a non-cannulated Herbert screw.
1Department of Orthopaedic Surgery, AZ St. Augustinus, Oosterveldlaan 24, 2610 Wilrijk, Belgium. joris_de_vos@hotmail.com
Chirurgie De La Main
|June 26, 2003
Summary
Percutaneous scaphoid fixation offers a rapid surgical option for scaphoid fractures, enabling immediate mobilization. This technique, using a Herbert screw, shows comparable results to literature, even for proximal pole fractures.
Area of Science:
- Orthopedic Surgery
- Traumatology
Background:
- Conservative treatment of scaphoid fractures leads to significant morbidity.
- Young, active populations are particularly affected by physical and economic consequences.
Purpose of the Study:
- To describe and evaluate a specific technique for acute percutaneous scaphoid fixation.
- To assess the efficacy of using a non-cannulated Herbert screw passed through the trapezium.
Main Methods:
- A retrospective review of 44 patients treated between 1996 and 2001.
- Description of a freehand screw placement technique through the trapezium.
- Comparison of results with existing literature on percutaneous scaphoid fixation.
Main Results:
- The described technique yielded results comparable to literature findings for percutaneous scaphoid fixation.
- Good outcomes were observed in proximal pole fractures, an area not typically indicated for this technique.
- All cases of delayed and non-union occurred in proximal pole fractures.
Conclusions:
- Acute percutaneous scaphoid fixation with a Herbert screw is a viable option, even for certain proximal pole fractures.
- While effective, the technique requires significant three-dimensional anatomical knowledge and has a learning curve.
- Proximal pole fractures treated with this method showed a higher incidence of delayed/non-union, warranting caution.