Clinical Effects of Herbert Screw Combined with Bone Flap on Scaphoid Nonunion

Abstract：Objective To discuss clinical effects of Herbert screw combined with bone flap on scaphoid nonunion.Methods 18 patients with scaphoid nonunion between Mar.2011 and Mar.2016 were analyzed retrospectively.There were 14 males and 4 females with an average age of 30.7 years old(range from 21 to 54 years old).The average time from injury to operation was 14.2 months(range from 5 to 25 months).All the 18 cases were treated with Herbert screw combined with vascularized bone flap surgery,including 12 cases with radius dorsal cortex bone flap with vascular pedicle and 6 cases with radial artery grafts supported radial styloid.Results All patients were followed up for 6 to 24 months.All fractures were healing,in which 11 cases were excellent,5 cases were good,and 2 cases were fair according to Mayo wrist function evaluation.Navicular angle,scapholunate angle,Mayo wrist function score,range of motion,grip strength were improved significantly at the final follow-up.Conclusion Herbert screw combined with vascularized bone flap for scaphoid nonunion is a method of mechanical fixation and biological fixation with good clinical efficacy.