Percutaneous herbert screw fixation of undisplaced scaphoid fractures-evaluation of functional and radiological outcome

Background: On undisplaced scaphoid fractures treated with prolonged cast immobilisation may result in temporary joint stiffness and muscle weakness in addition to a delay in return to sports or work. Fixation of scaphoid fractures with a percutaneous screw has resulted in a shorter time to union and to return to work or sports. The purpose of this study was to evaluate the results of percutaneous screw fixation scaphoid fractures with respect to time to radiographic union and to return to work. Materials and Methods: In 20 patients with fracture of the scaphoid, fixation with a percutaneous screw was done. Time to fracture union, wrist motion, grip strength and return to work as well as overall patient satisfaction at the time of a two-year follow-up were evaluated. Results: Of the 20 patients in the study, mean radiological fracture union time was 12.2 weeks (range 8-15 weeks). Wrist function was excellent in 10 cases, good in remaining 6 cases and poor in 4 cases. Conclusion: Percutaneous herbert screw fixation is a well-documented surgical procedure. Undisplaced scaphoid fractures fixed by percutaneous headless screw fixation yield better results than patients treated conservatively. Good range of motion is achieved after fixation. It relieves pain and functional disability experienced by patients. Percutaneous screw fixation of scaphoid fractures resulted in faster radiographic union and return to function. The specific indications for and the risks and benefits of percutaneous screw fixation of such fractures must be determined in larger randomised prospective studies.