Percutaneous Fixation of Recent Scaphoid Fracture by Herbert screw through the Volar Approach: A Clinical Trial. | ||||
| International Journal of Medical Arts | ||||
| Articles in Press, Accepted Manuscript, Available Online from 06 August 2025 | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ijma.2025.386954.2189 | ||||
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| Authors | ||||
Hassan Ibrahim Amer  1; Samir Ahmed Nematallah2; Mohamed Mostafa Elmenawi3
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| 1Resident of Orthopedic Surgery, Orthopedic Department, Damietta faculty of medicine, Al Azhar university, Egypt. | ||||
| 2Lecturer of orthopedic surgery, Orthopedic Department, Damietta faculty of medicine, Al Azhar university, Egypt. | ||||
| 3Professor of orthopedic surgery, Orthopedic Department, Damietta faculty of medicine, Al Azhar university, Egypt. | ||||
| Abstract | ||||
| Background: The scaphoid is the most frequently broken bone in the wrist, representing between 50% and 80% of all carpal fractures and about 11% of hand fractures overall. These injuries are most often seen in young, physically active individuals. The approach to treating acute scaphoid fractures varies based on several considerations, such as the degree of displacement, the fracture’s anatomical location, the presence of comminution, and the patient’s lifestyle or occupation. Minimally invasive fixation techniques, such as percutaneous screw fixation, are often used for stable, non-displaced fractures. This method was initially introduced by Streli in 1970. Aim of the study: The aim of this study is to evaluate prospectively the clinical outcome of percutaneous fixation of 15 patients with fresh scaphoid fractures by Herbert screw, subjectively and objectively, over 10 months using the modified Mayo wrist score (MMS) as the final postoperative evaluation. Patients and methods: This study involved adult patients with closed scaphoid fractures who were treated using the volar percutaneous fixation technique at Damietta Hospital, Al-Azhar University, between December 2023 and December 2024. The collected data were coded, reviewed, and entered into IBM SPSS version 20 for statistical analysis. Results: This prospective study included 15 patients with closed scaphoid fractures. The cohort consisted of 12 males (80%) and 3 females (20%), with a mean age of 30.93 years (range: 21–50 years). At final follow-up, 12 patients (80%) achieved excellent outcomes, while the remaining 3 patients (20%) had good outcomes according to the Modified Mayo Wrist Score (MMWS). Conclusions: Percutaneous screw fixation offers stable osteosynthesis for non-displaced or minimally displaced scaphoid waist fractures, promoting faster bone healing, earlier return to daily activities, and reducing the risks of muscle atrophy and grip strength loss associated with extended immobilization in a cast. | ||||
| Keywords | ||||
| Herbert screw; Minimally invasive; Percutaneous fixation; Scaphoid | ||||
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