Evaluation of Herbert screw fixation for the treatment of displaced scaphoid nonunions

Ten cases of unstable scaphoid nonunions treated with Herbert screw fixation were compared to nine cases treated with Herbert screw fixation supplemented with a single Kirschner wire (K-wire) across the fracture site. Corticocancellous bone graft from the distal radius was used in all cases to reconstruct the scaphoid. The age of the patients and duration of the nonunions were similar in both groups. Postoperative radiographs demonstrated that only 5 of 10 patients with Herbert screw fixation alone healed, while 8 of 9 patients with Herbert screw and K-wire fixation healed. The time to union averaged 4.9 months in the patients supplemented with a K-wire and 7.8 months in those patients without the K-wire.