Comparison between Kirschner's wire and Herbert's screw fixation in Scaphoid nonunion

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Journal of the Korean Society for Surgery of the Hand 1999;4(2):149-156.
Published online January 1, 1999.

Soo Bong Hahn,Eung Shick Kang,Ho Jung Kang,Jeong Min Lee,Sang Jin Shin

주상골 불유합의 치료에 있어 Kirschner 강선과 Herbert 나사못 고정술의 비교

한수봉,강응식,강호정,이정민,신상진

Abstract

We reviewed the 30 cases of patients who underwent open reduction and internal fixation (O/R & I/F) with Kirschner's wire or Herbert screw with autogenous bone graft, compared and reported the results of treatment. In 30 cases, O/R & I/F with Kirschner's wire combined with cancellous bone graft was done for 14 cases, and O/R & I/F with Herbert screw combined with bone graft for 16 case. We reviewed the duration of union, complication and the results of treatment by the Maudsley criteria. Among 30 cases, all cases were male and average duration 34 months. In union time, Kirschner's wire fixation group had 25.3 weeks. In distal Herbert screw insertion group with cancellous bone graft, union was achieved at 18.5 week, in block bone graft group, 21.1week. It took 22 weeks for proximal insertion group. Among 14 cases with Kirschner's wire fixation 10 had an excellent or good result, while among 16 cases with Herbert's screw fixation 14 had such results according to Maudsley & Chen protocols. we concluded that Herbert screw fixation was the better method in treatment of scaphoid nonunion. This method had a shorter duration for union and better results compared with Kirschner's wire fixation. In addition, cancellous bone grafting had a shorter duration for bony union than block bone grafting.

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