Efficacy of Percutaneous Herbert screw fixation for treating delayed union and nonunion of the Scaphoid.

Authors

  • Muhammad Khizer Hayat Makki Fellow of Hand Surgery, National Orthopaedic and General Hospital, Bahawalpur
  • Muhammad Ali Fellow of Hand Surgery, National Orthopaedic and General Hospital, Bahawalpur
  • Tahseen Ahmad Cheema Chief Surgeon, National Orthopaedic and General Hospital, Bahawalpur
  • Hussan Birkhez Shami Consultant Hand and Plastic Surgeon, National Orthopaedic & General Hospital, Bahawalpur
  • Hafiz Muhammad Ahmad Qureshi Medical Officer, Bahawal Victoria Hospital, Bahawalpur
  • Muhammad Qasim Qureshi House Officer, CMH, Bahawalpur

Abstract

Objective: To determine the radiological outcome of percutaneous Herbert screw fixation in delayed union and nonunion of the Scaphoid.

Methods: This descriptive study was conducted in National orthopedic and General Hospital Bahawalpur from 20th February 2018 to 20th March 2022.All adults patients with Scaphoid delayed union and non fulfilling the inclusion criteria were treated with percutaneous Herbert screw fixation without bone grafting. Post operative radiographic union was determined at five months.

Results: The data of 9 patients fixed with percutaneous Herbert screw fixation were analyzed. All patients were male with mean age of 26±5 years. Delayed union was present in 5(55.55%) patients and non union in 4(44.44%). All fractures achieved radiological union in 15.5±4.2 weeks. Postoperative wrist stiffness was noted in 2(22.22%) patients and was treated with physical therapy. No patient required revision surgery.

Conclusion: Delayed union and nonunion of the Scaphoid can be treated successfully with Percutaneous Herbert screw fixation as shown by excellent radiological union in all of our cases.

References

Guo Y, Ma W, Tong D, Liu K, Yin Y, Yang C. Robot-assisted double screw fixation of minimally displaced scaphoid waist fracture nonunions or delayed unions without bone graft. J Hand Surg Eur Vol. 2021;46(3):286-291.

Ernst SMC, Green DP, Saucedo JM. Screw Fixation Alone for Scaphoid Fracture Nonunion. J Hand Surg Am. 2018 ;43(9):837-843.

Gurger M, Yilmaz M, Yilmaz E, Altun S. Volar percutaneous screw fixation for scaphoid nonunion. Niger J Clin Pract. 2018;21(3):388-391.

Matic S, Vuckovic C, Lesic A, Glisovic Jovanovic I, Polojac D, Ducic S, Bumbasirevic M. Pedicled vascularized bone grafts compared with xenografts in the treatment of scaphoid nonunion. Int Orthop. 2021;45(4):1017-1023.

Liu B, Wu F, Ng CY. Wrist arthroscopy for the treatment of scaphoid delayed or nonunions and judging the need for bone grafting. J Hand Surg Eur Vol. 2019 ;44(6):594-599.

Ohta S, Ikeguchi R, Noguchi T, Kaizawa Y, Oda H, Yurie H, Matsuda S. Percutaneous Fixation for Scaphoid Nonunion with Bone Grafting Through the Distal Insertion Hole of a Fully Threaded Headless Screw. J Hand Surg Asian Pac Vol. 2016;21(3):357-363.

Sahu SK. Functional outcome of minimally invasive percutaneous Herbert screw fixation with cancellous bone graft in delayed union or non-union scaphoid fractures with minimal sclerosis. Int J Orthop Sci. 2016;2(3):108-112.

Van der Sluis CK, Dekker R. Injuries of Wrist, Hand and Fingers. In: Nuclear Medicine and Radiologic Imaging in Sports Injuries. Berlin: Springer ; 2015.

Janowski J, Coady C, Catalano III LW. Scaphoid fractures: nonunion and malunion. J Hand Surg. 2016 ;41(11):1087-1092.

Wong K, von Schroeder HP. Delays and poor management of scaphoid fractures: factors contributing to nonunion. J hand surg. 2011;36(9):1471-1474.

Luchetti TJ, Rao AJ, Fernandez JJ, Cohen MS, Wysocki RW. Fixation of proximal pole scaphoid nonunion with non-vascularized cancellous autograft. J Hand Surg Eur Vol. 2018;43(1):66-72.

Saint-Cyr M, Oni G, Wong C, Sen MK, LaJoie AS, Gupta A. Dorsal percutaneous cannulated screw fixation for delayed union and nonunion of the scaphoid. Plast Reconstr Surg. 2011 ;128(2):467-473.

Inaparthy PK, Nicholl JE. Treatment of delayed/nonunion of scaphoid waist with Synthes cannulated scaphoid screw and bone graft. Hand. 2008 ;3(4):292-296.

Dedeoglu SS, Imren Y, Cabuk H, Tekin AC, Ture YC, Gurbuz H. Results of percutaneous fixation and distal radius core decompression in scaphoid waist non-unions treated without grafting. Hand Surg Rehab. 201837(1):43-47.

Slade JF 3rd, Geissler WB, Gutow AP, Merrell GA. Percutaneous internal fixation of selected scaphoid nonunions with an arthroscopically assisted dorsal approach. J Bone Joint Surg Am 2003; 85-A (Suppl 4): 20-32.

Farnell RD, Dickson DR. The assessment and management of acute scaphoid fractures and non-union. Orthop T. 2010;24(5):381-393.

Soubeyrand M, Biau D, Mansour C, Mahjoub S, Molina V, Gagey O. Comparison of percutaneous dorsal versus volar fixation of scaphoid waist fractures using a computer model in cadavers. J hand surg. 2009;34(10):1838-1844.

Vanhees M, van Riet RR, van Haver A, Kebrle R, Meermans G, Verstreken F. Percutaneous, transtrapezial fixation without bone graft leads to consolidation in selected cases of delayed union of the scaphoid waist. J wrist surg. 2017;6(03):183-187.

Kim JK, Kim JO, Lee SY. Volar percutaneous screw fixation for scaphoid waist delayed union. Clin Orthop Relat Res 2010; 468: 1066-7101.

Capo JT, Shamian B, Rizzo M. Percutaneous screw fixation without bone grafting of scaphoid non-union. Isr Med Assoc J. 2012 ;14(12):729-732.

Downloads

Published

2022-09-14

How to Cite

Muhammad Khizer Hayat Makki, Muhammad Ali, Tahseen Ahmad Cheema, Hussan Birkhez Shami, Hafiz Muhammad Ahmad Qureshi, & Muhammad Qasim Qureshi. (2022). Efficacy of Percutaneous Herbert screw fixation for treating delayed union and nonunion of the Scaphoid. Journal of Pakistan Orthopaedic Association, 34(03), 102–105. Retrieved from http://game.myvmk.com/index.php/upload/article/view/666