Scaphoid Fractures: A Comparison of Two Surgical Methods for Internal Fixation Using Either Herbert Screws or Multiple Pins

Authors

1 Assistant Professor, Orthopedics Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran

2 General Practitioner, Orthopedics Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran

3 Student of Medicine, Orthopedics Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran

Abstract

Background and Aims: Scaphoid fractures are the most common fractures of the wrist. This study compared the outcomes of two surgical internal fixation techniques, using either Herbert screws (HS group) or multiple pins (MP group), in the treatment of scaphoid fractures. Methods: This cross-sectional study was performed on 41 patients (23 in HS and 18 in MP groups) with unilateral scaphoid fractures from September 2009 to September 2011. All patients were followed-up two weeks post-surgery, every month for six months, and then every year after one year. Degree of fracture healing, measured level of pain using Visual Analog Scale (VAS), range of motion, hand grip strength of affected limb vs. healthy limb, Quick DASH score (QD) and also Mayo Modified Wrist Score (MMWS) were recorded. In December 2012, all patients presented to the Orthopedic Clinic for their final follow-up visit where all data was recorded once more. Results: Mean patient follow-up time was 24.34 ± 8.70 months (range: 11-34). Mean scaphoid fracture healing times for the HS and MP group were 14.61 3.88 and 14.39 4.27 weeks, respectively. No statistically significant difference was found between both groups after comparing mean levels of pain using VAS, ROM of wrist during flexion and extension, hand grip strength expressed as percentage of normal, QD, and MMWS. The level of patients' content using VAS was 9.5 for HS and 9.0 for MP groups. Conclusion: The use of multiple pins for the internal fixation of scaphoid fractures proves to be a viable treatment option compared to Herbert Screws, due to decreased cost and increased availability.

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