Treatment of nonunions of the scaphoid by iliac bone grafting and Herbert screw fixation

Abstract

Fractures of the scaphoid most frequently occur in the active, young, adult male and, delayed union or nonunion rates are high because of the special blood circulation of this bone. As a result of scaphoid bone nonunions, carpal instability, pain, limitation on wrist motion, decrease on grip strength and osteoarthrosis occur. In this study, between the years of April 1990- March 1997, 13 scaphoid nonunions were evaluated retrospectively by the Department or Orthopaedic Surgery and Traumatology in Ondokuz Mayis University. All of the cases were treated by open reduction + cortico-cansellous iliac bone grafting + Herbert screw fixation. The results were evaluated according to Herbert-Fisher's criteria. The rate of the excellent and good results was 84.6%, and the rate of the fair and poor results was 15.4%. In conclusion, treatment of nonunions of the scaphoid bone by iliac bone grafting are corrected scaphoid bone anatomy with rapidly union and are prevented carpal instability. Treatment of nonunions of the scaphoid bone by Herbert screw fixation are constructed rigit internal fixation, and are provided early wrist motion with shorter immobilization time.