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Document Type

Original Article

Abstract

Background: Scaphoid nonunions are challenging to treat due to the bone's unique shape, the specifics of the fracture's orientation and kind, and the unique vascular arrangement of the scaphoid's blood supply. Aim and Objective: To evaluate the relative utility of Herbert screw versus Kischner wires in management of scaphoid waist fracture non-union using non vascularized bone graft regarding efficacy, functional outcome, operative time and complication. Patients and methods: This research was performed in the orthopedic surgery department at Al-Azhar University with scaphoid waist non-union fracture, throughout the time span of January 2022 - December 2022. A total of 20 cases with scaohiod waist non-union fracture were treated with corticocancellous iliac bone graft with internal fixation by Herbert screw or multible k wires. We continued to check up with our cases for a minimum of 6 months. Clinical (pain –Rom-Power grip strength), radiographs. Modified Mayo's wrist score and Dash score was the main clinical outcome indicator.
Results: All fractures united in a mean of 7 ±2 months in Herbert screw groups and 6 ±3.6 months in K-wire group. More than three fourth of the participants (80%) didn’t acquire complications. 10% of the participants suffer from Pin tract infection. 10 % suffer from Mal-union. The overall clinical & functional outcomes, as stated by the scoring system of Mayo, showed that 8 cases (40%) had excellent results, 6 (30%) had good results, 4 (20%) had satisfactory results, and 2(10%) had poor results. Conclusion: Internal fixation by k wires versus Herbert screw by bone graft was a good option for treatment of scaphoid waist non-union fractures. We prefer using k wires because of shorter operative time, lesser cost and Simpler to use than the Herbert screw.

Keywords

scaphoid; scaphoid waist; Nonunion; krishner wires; Herbert screw.

Subject Area

Orthopedics

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