HERBERT SCREW FIXATION OF SCAPHOID FRACTURES

We reviewed the records of 431 patients who had open reduction and int ernal fixation of the scaphoid performed by one surgeon (TJH) over a 1 3-year period, The Herbert bone screw provided adequate internal fixat ion without the use of plaster immobilisation, promoting a rapid funct ional recovery, On average, patients returned to work 4.7 weeks after surgery and wrist function was significantly improved, even when the f racture failed to unite, Healing rates for acute fractures were better than those reported for plaster immobilisation and were independent o f fracture location, In the case of established nonunions, healing dep ended on the stage and location of the fracture, but the progress of a rthritis was halted and carpal collapse significantly improved, Intern al fixation of the scaphoid using the Herbert bone screw, although tec hnically demanding, has few complications and appears to offer signifi cant advantages over other methods of treatment.