Treatment Of Unstable Fracture Of Scaphoid With CBS

Scaphoid fracture is the most common fractures in the carpal bones,because of the special anatomic property,it is liable to be missed diagnosis, inappropriate treatments may lead to nonuion and avascular necrosis of the proximal fragment.The use of Herbert screw elevated the union rate obviously,and now there are several modified headless screws.In order to explore the therapeutic effect of cannulated bone screw and accumulate experience ,we analysis four cases of unstable scaphoid fracture treated with CBS in our department from February to September in 2007.The cases include 3 males and 1 female,the average age is 24.75,there are 1 case of type B2 and 3 cases of type C according to Herbert's classification system.After 6-13 months follow up,4 cases synostosis ,the average union time is 3.5 months,the proximal pole of scaphoid necrosis in 1 case.According to Krimmer wrist scoring,there are three good cases,and one acceptable case.We suggest that CBS is refer to displaced scaphoid fracture,fractures with complicated dislocation or cases need bone grafting or nerve,tedon exploring.And radius is a good donar place for bone graft.CBS assure firm internal fixation,promote the union of scaphoid . Postop mobilization is profit for functional recovery.But besides the treatment methods, its primary injuries is closely related to the prognosis.