Scaphoid Fracture Surgery - Ian McDermott 20/3/2001

OPERATIVE TREATMENT

Brief FILAN & HERBERT JBJS-B 1996
Author Filan S.L. & Herbert T.J.
Title Herbert Screw Fixation of Scaphoid Fractures
Reference JBJS 1996; 78-B (4): 519-529
Summary

o 88% union in acute #s. 86% pain free. 91% back to work after mean of 4.7 weeks.

o Most type B #s were unstable and 1/3 had soft tissue interposition - poor correlation with pre-op X-rays.

o Most common complication = tender hypertrophic scar (in 13%).

Critique Retrospective review of 304 (out of 431) cases performed by Herbert. 82 acute, # 349 non-unions over a 13 year period. Mean FU 34.2 months. Min FU 6 months.

Brief RAUDASOJA ANN. CHIR. GYNAECOL 1999
Author Raudasoja L, Rawlins M, Kallio P & Vasenius J
Title Conservative Treatment of Scaphoid Fractures: A Follow Up Study
Reference Annales Chirurgiae et Gynaecologiae 1999; 88: 289-293
Summary

o 89% union

o 34% complained of residual symptoms (most were mild)

o mean time back to work = 9 weeks

o OA in 32%, but not correlated with symptoms

Critique Retrospective review of 63 (out of 125) patients. Mean FU 54 months. #s with >2mm displacement were treated surgically.



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