[Treatment of old scaphoid fracture with absorbable screw].

OBJECTIVE

To explore a new approach to treat old scaphoid fracture by grafting bones from distal radius and fixing absorbable screws.

METHODS

From January 2002 to May 2007, 18 patients with old scaphoid fractures were treated by grafting bones from distal radius and fixing absorbable screws. All of the 18 patients (13 males and 5 females, aged from 17 to 41 years old) had the injury history of the palm of hand touching the ground. They felt tenderness on the anatomical snuff-box and tubercle of scaphoid bone. The grasping force decreased. The range of motion of the wrist was (36 +/- 2) degrees extension/(30 +/- 3) degrees flexion, (8 +/- 3) degrees radialis/(13 +/- 2) degrees ulnaris.

RESULTS

The average postoperative follow-up period was 15.7 months. A total of 18 cases achieved bone union. The range of motion of the wrist in the 16 healed cases was (68 +/- 2) degrees extension/(65 +/- 3) degrees flexion, (15 +/- 3) degrees radialis/(28 +/- 5) degrees ulnaris. There was no pain of motion and symptom of powerlessness. As to the other 2 cases, the range of motion of the wrist was (40 +/- 8) degrees extension/(35 +/- 6) degrees flexion, (8 +/- 5) degrees radialis/(12 +/- 5) degrees ulnaris; no obvious improvement was found; the patients occasionally felt painful in daily life; the extension force decreased. No infection and break of internal fixation were seen.

CONCLUSION

The absorbable screw as a new biomaterial for internal fixation has obvious advantages of good biocompatibility, promoting union of the fracture and no need of a second operation for removal.