Treatment of Herbert type I scaphoid fractures by percutaneous cancellous cannulated screw fixation

Objective To compare the clinical results of percutaneous cancellous cannulated screw fixation and cast immobilization for treatment of Herbert type Ⅰ scaphoid fractures. Methods 46 patients with fresh Herbert type Ⅰscaphoid fractures were divided into two groups randomly, percutaneous cancellous cannulated screw fixation group (26 cases) and cast immobilization group (20 cases). CT scan of the wrist was done once every 2 weeks till evidence of bone healing was present. Time of fracture union, time return to work, wrist motion, and grip strength were recorded and compared. Results All cases were followed for 10 to 27 months with an average of 18.3 months. All patients in the screw fixation group and 18 out of 20 in the cast group achieved bony union, the healing rate being 100% and 90% respectively. The average time of union of the two groups was 7.5 weeks and 13.5 weeks (P0.01), and the time return to work was 8.9 weeks and 15.7 weeks (P0.01) respectively. There were no statistically significant differences in the range of motion of the wrist and the grip strength. Conclusion Percutaneous cancellous cannulated screw fixation has better results than cast immobilization in the treatment of Herbert type I scaphoid fractures.