Treatment of old scaphoid fractures by internal fixation with modified common screws / 中华创伤骨科杂志

ABSTRACT

Objective To introduce treatment of old scaphoid fractures by internal fixation with common screws which have been modified into compression-like ones.Methods Twenty-five patients with old scaphoid fracture were admitted to our department from January,1995 to December,2002.They were 17 cases of delayed union,and eight cases of non-union and pseudoarticulation formation.All the patients were treated with open re- duction anti internal fixation by modified common cortical bone screws,some threads of which bad been erased so that they could act somewhat like compression ones.The modified screws were driven into the reduced scaphoid by simple surgical instruments to fix and compress the fracture ends.Results Nineteen cases were followed up for one to six years (mean,3 years).Fourteen cases of fracture healed,with an average healing time of 7 months.The mean extension-flexion arc of the injured wrists was between 106 degrees and 128 degrees.Three cases failed to heal,and two cases experienced deformed and sunken proximal scaphoid.Conclusions Common cortical bone screws can be easily changed into compression-like ones to treat old scaphoid fractures and result in satisfactory,clinic outcome.In addition,they are easily available,can be inserted through joint facet with limited negative effect on the joint,and play a double role of compression and fixation.