[Surgical treatment of scaphoid pseudarthrosis--long term outcome with the Herbert screws]

Between 1984 and 1993, 131 scaphoid nonunions were treated with iliac crest bone grafting and the Herbert-screw. 105 patients were followed between one and ten years with an average followup period of 4.5 years. Bony union was achieved in 93 patients with improvement of range of motion and grip strength. In 14 patients with DISI-instability, the angulation deformity was incompletely corrected with an average reduction of the scapho-lunate angle of eleven degrees. Limited athritic changes at the radial styloid were noted in 58%, intercarpal in 25% of the patients. Most frequent reasons for persistent nonunion were technical problems with the Herbert-screw.