Acute stable scaphoid fractures (Herbert typeA2) are generally managed conservatively with a plaster cast. But long-term immobilization in a plaster cast causes limitations in daily living and work. We treated acute stable scaphoid fractures surgically using a Herbert screw without requiring a cast and then compared the results obtained following surgical treatment to that following conservative management.
13 wrists were conservatively treated with a plaster cast Patients comprised 12 males and 1 female with an average age of 27.9 years. The average time of fixation with the plaster cast was 8.2 weeks. In comparison 19 wrists of 19 male patients were treated surgically. The average age of the patients was 26.6 years. We evaluated the results of both groups using symptons and roentogengrams.
At follow-up no patients had wrist pain or limitation in daily living. The average time for bone union was 10 weeks in the conservatively treated group, and 7 weeks in those who were operated on.
Herbert screw fixation through a small skin incision is useful for treating acute stable scaphoid fractures because it frees the patient from the inconvenience of wearing a plaster cast.
