Palmar Percutaneous Cannulated Herbert-Whipple Screw Fixation of Scaphoid Fractrues

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Journal of the Korean Society for Surgery of the Hand 2005;10(3):129-135.
Published online September 1, 2005.

Il-Hoon Sung, Jae-Hong Jung, Kwang-Hyun Lee, Choong-Hyeok Choi, Jong-Pil Yoon

주상골 골절에서 수장측 경피적 유관 Herbert-Whipple 나사 고정술

성일훈, 정재홍, 이광현, 최충혁, 윤종필

Abstract

Purpose
The purpose of this study is to evaluate the radiologic and clinical results of percutaneous cannulated Herbert-Whipple screw fixation with free hand technique by volar approach. Methods: We surveyed 10 patients, 10 cases from Nov. 2003 to Apr. 2005, who were treated scaphoid fracture with percutaneous cannulated Herbert-Whipple screw fixation with free hand technique by volar approach. There were 9 men and 1 woman, and mean age was 31.3(21~36)years. Post-operative management was carried out by application of short arm brace for 2 weeks and then performed active and passive ROM exercise. At first, we checked serial radiographs by 2 weeks and CT scan to confirm anatomical reduction and bony union. Mayo wrist score was used for functional result at final follow up. Results: 9 patients were B2 and one patient was B4 according to Herbert classification. In preoperative xray, mean intrascaphoid angles were 42.7˚(anteroposterior view, AP) and 30.7˚(lateral view), in postoperative x-ray they were measured 38.7˚(AP), 25.5˚(lateral). Bony union was achieved at mean 6.7(4-10) weeks. In all cases, we confirmed anatomical reduction and bony union by CT scan. Mean Mayo wrist score was 91.5 (80-100) points with 7 excellent and 3 good cases. There were no complications. Conclusions: In short term results, we could get excellent results by percutaneous Herbert-Whipple screw fixation. This technique allows early wrist exercise by firm fixation and does minimal damage to major structures of wrist.

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