Functional outcome of scaphoid nonunion treated with herbert screw and bone grafting
European Journal of Molecular & Clinical Medicine,
2020, Volume 7, Issue 10, Pages 3710-3715
AbstractAim: to evaluate the functional outcome of scaphoid nonunion treated with bone grafting and Herbert screw fixation.
Material and Methods: This study was done the Department of Orthopaedics, Vardhman Institute of Medical Sciences, Pawapuri, Nalanda Bihar, India from March 2016 to August 2017. 60 cases were referrals from peripheral centers with a possible diagnosis of scaphoid nonunion after failed conservative treatment. 60 patients were initially assessed with fresh radiographs and MRI wrist was taken in all cases. The injuries were classified according to Herbert’s Classification. Clinical examination included the assessment of tenderness, active and passive range of movement in wrist, and grip strengths were also measured. A firm padded removable splints were used to support the wrist for the first two weeks and after the suture removal, patients are advised to start mobilizing exercises of the wrist.
Results: There were 60 cases of scaphoid nonunion treated with Herbert screw fixation and cancellous bone grafting. All the patients were males and dominant hand was involved in 50 cases. Out of 60 patients 25 patients had road traffic accidents, 32 had fall on outstretched hand and 3 fracture caused by assault. The right wrist was affected in 50 cases and left in 10 patients. The mean time from injury to surgical fixation was 12 months. The mean age of the patients was 29.7 years. The occupations of the patients in terms of weight loading of the wrist were heavy loading in 37 patients, light loading in 10 patients and clerical work in 13 patients. Since all the patients were referral cases with nonunion, they were initially been all the 60 patients were regularly followed up and were evaluated for clinical and radiological outcomes.
Conclusion: the healing of the nonunion is better than that in other surgeries like k wire fixation or bone graft surgeries alone.
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