PMID: 24340524Dec 18, 2013Paper

Percutaneous Herbert screw osteosynthesis in trans-scaphoid perilunate fracture-dislocations

Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din Iaş̧i
O Alexa, B Veliceasa

Abstract

Trans-scaphoid perilunate fracture-dislocation is the most common variety of fracture-dislocations of the wrist. Because of the carpal scaphoid fracture association, post-reduction stability is poor, often requiring surgery. Of the several surgical techniques used over time, percutaneous screw fixation for scaphoid fracture is currently preferred. Six cases of trans-scaphoid perilunate fracture-dislocation were surgically treated by percutaneous reduction of the scaphoid fracture and percutaneous insertion of Herbert screw in a proximal to distal manner. Postoperative immobilization was followed by rapid resumption of wrist mobility. Four of the six patients have resumed normal, painless mobility of the wrist within 3 to 6 weeks post immobilization; in the remaining two cases there were a slight wrist stiffness attributed to persistent slight rotatory deficiency between the fractured scaphoid fragments. The percutaneous Herbert screw fixation provides a firm fixation with good compaction of scaphoid fracture, enough stability to allow minimal soft tissue and local damage, early mobilization following minimal immobilization, and thus rapid healing.

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