Herbert Screw, Non-Union Fracture, Scaphoid, Union, Volar Buttress Plate
Conditions
Brief summary
This study aimed to evaluate the short-term results of treating non-united scaphoid waist fractures with a humpback deformity by graft and internal fixation using a volar buttress plate versus the use of a Herbert screw.
Detailed description
Scaphoid fracture is the most common fracture, accounting for roughly 60% of the total carpal bone fractures and 11 % of all hand fractures. Nonunion occurs in approximately 5% to 25 % of scaphoid fractures. The scaphoid nonunion will collapse into a humpback deformity, and the lunate, together with the proximal pole, into a dorsal intercalated segment instability, which might end in an advanced carpal collapse. A scaphoid screw acts to prevent bending at the fracture site with three-point fixation within the cancellous bone of the scaphoid. The proximal and distal points of purchase are achieved by the capture of the screw threads in the cancellous bone of the proximal and distal poles of the scaphoid. The third point occurs within the cancellous bone of the scaphoid waist.
Interventions
PROCEDUREVolar buttress plate
Patients will be treated by a volar buttress plate.
PROCEDUREHerbert screw
Patients will be treated by Herbert screw.
Sponsors
Helwan University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
20 Years to 50 Years
Healthy volunteers
No
Inclusion criteria
* Age of a patient is between 20 years to 50 years. * Non-union or delayed union scaphoid wrist fracture (more than 3 months). * Closed fracture. * Patients without previous scaphoid surgery. * Patients without abnormal renal and/or liver functions. * Patients without hypocalcemia and/or vitamin D3 deficiency.
Exclusion criteria
* Open fracture. * Patients with proximal or distal fracture of the scaphoid. * Patients with avascular necrosis of scaphoid. * Patients with mid-carpal arthritis or pan-carpal arthritis. * Patients with carpal instability.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Mayo Wrist Score | 3 months post-procedure | The Mayo Wrist Score is a fast and simple tool comprising four questions that assess pain intensity, wrist function, range of motion, and grip strength. Mayo Wrist Score ranges from 0 to 100. Scores of 90-100 are considered excellent, 80-90 good, 60-80 satisfactory, and below 60 poor. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Disabilities of the Arm, Shoulder and Hand (DASH) score | 3 months post-procedure | The Disabilities of the Arm, Shoulder and Hand (DASH) is a 30-item patient-reported outcome measure utilized to assess symptoms and function of the entire upper extremity. The score is calculated on a scale score ranging from 0 (no disability) to 100 (most severe disability). |
Countries
Egypt
Outcome results
None listed