Treatment of scaphoid non-unions with a corticocancellous graft and Herbert screw fixation: results at five years follow-up.

In a retrospective survey, 16 patients with 18 established nonunions of the scaphoid treated with a sandwich graft and Herbert screw fixation, were reviewed: 14 patients were very satisfied with the outcome. The mean DASH score was 17 (SD 18.4). Flexion was 76%, extension 79% and gripping force 85% of the contralateral side. Union was achieved in 13 scaphoid bones. There was a significant increase in carpal height. Despite these findings there was also an increase in osteoarthritis. However this was not related to the correction or absence of correction of the preoperatively existing DISI. There was no correlation between radiological presence of osteoarthritis and clinical outcome.