Functional outcome of minimally invasive percutaneous Herbert screw fixation with cancellous bone graft in delayed union or non-union scaphoid fractures with minimal sclerosis

Abstract

The best treatment for scaphoid nonunion fractures is still controversial. The objective of this article is to report our clinical experience in the treatment of patients with scaphoid fracture with delayed union or non-union with minimal sclerosis using percutaneous cancellous bone graft and Herbert’s screw and to study the functional outcome with an average of one year follow-up. We reviewed 35 patients treated with percutaneous cancellous bone graft and Herbert’s screw fixation from October 2012 to January 2016. Preoperative clinical manifestations and postoperative results were assessed by radiography, and functional results, including grip force, range of motion of the wrist joint, and Cooney’s scoring chart, were evaluated. The union rate was 91.42%. The average grip power, as well as wrist flexion and extension were significantly improved. Using Cooney’s scoring system, 28(80%) patients were rated excellent and 4(11.42%) good. For successful union, anatomical reduction with cancellous bone grafting and Herbert’s screw fixation is definitely a reliable option. This method leads to a satisfactory functional outcome.