The Herbert screw for the treatment of scaphoid fractures.

Forty-nine patients with fifty fractures of the scaphoid were reviewed more than six months after surgical treatment using the Herbert bone screw. Twenty-nine patients (mainly those with delayed union and non-union) also had bone grafts. The mean period of follow-up was 18.3 months. In 47 patients (94%) the fracture had definitely or probably united. The three patients whose fractures did not unite had proximal pole fractures with pre-existing avascular necrosis and osteoarthritis. Immediate post-operative mobilisation was possible in thirty patients. Wrist function as measured by grip strength and range of motion was excellent or good in most patients. Twenty patients had proximal pole fractures and their results are analysed separately.