[Comparison between fixation with Herbert screws and Kirschner wires in the treatment of scaphoid XXXX ].

@entity1 @entity174 @entity1516
OBJECTIVES: To compare the treatment results of @entity1 with scaphoid @entity1516 , who were treated by autogenous cancellous bone grafting followed by fixation with Herbert screws or Kirschner wires. METHODS: The study included 19 @entity1 (mean age 28 years, range 20 to 41 years) who were treated for scaphoid @entity1516 and had a minimum follow-up of 12 months. Treatment was comprised of autogenous cancellous bone grafting and fixation with Herbert screws (n=10) or Kirschner wires (n=9). Fifteen right and four left hands were affected. The mean duration between the traumatic event and surgery was 20 months (range 3 to 72 months). @entity174 were localized in the proximal pole (n=4, 21%), waist (n=13, 68%), and in the distal pole (n=2, 11%). The mean follow-up was 16 months for Herbert screws, and 21 months for Kirschner wires. RESULTS: None of the @entity1 exhibited a loss in range of motion of 10 degrees or more. The mean time to union was six months (range 3 to 20 months) with Herbert screws and eight months (range 4 to 22 months) with Kirschner wires. All @entity1 had union with Kirschner wires, whereas non-union occurred in three @entity1 with Herbert screws, two of whom had had proximal pole fractures. Radiologic outcome was significantly different between the two groups (p<0.01). CONCLUSION: Because of good vascularity and union potential, scaphoid @entity1516 can be successfully treated by an appropriate surgical technique using autogenous cancellous grafting independent of fixation materials.
