Neglected Scaphoid Fracture treated with Herbet Screw and Bone Graft in Man 13
years old and 31 years old
Nyoman Orthi Laksana* Made Bramantya Karna**
* Department of Orthopaedy and Traumatology resident, Sanglah General Hospital, Udayana University, Bali
** Department of Orthopaedy and Traumatology staff, Sanglah General Hospital, Udayana University Bali
Introduction
Neglected or misdiagnosed, non-union of a scaphoid fracture will almost made progress of pain and become osteoarthritis of the wrist with lifelong disability, especially in young males in which the fracture is more common. Fractures of the scaphoid bone are the most common fractures of the carpus and second in occurrence among fractures of the wrist. The diagnosis and treatment are not simple. Familiarity with different imaging methods and treatment options is required. The treatment in most cases is conservative and will lead to uneventful union, but an operation may be needed in certain cases primarily and in the treatment of non-union.
Cases
We have two cases of neglected scaphoid fracture which treated using Herbet screw and bone graft. After 3 month we evaluate the patient in clinically and radiographic ( X Ray )
1. Male, 13 years old complain pain on his right radial side of the wrist since one years ago. He was play football, slipped and fell with his right hand withstand the body. A history treated with bone setter one time, then after the next year he treated with herbet screw and bone graft
2. Male, 31 years old complain pain on his left radial side of the wrist since 4 month ago. He had traffic accident when he rode a motorcylcle, hit another motorcycle infront of him then fell with outstretched hand. He also treated with herbet screw and bone graft
Both are the same time of operation, on May 2014, with the same method, as a result with clinically with reduce of pain, no more limited of movement
Discussion
The goal is stablize with herbet screw that can be achieve the original alignment, and apply bone graft to preserve the blood supply that healing is also achieve, also immobilize in short cast. Stability of fracture fixation depends on: Bone quality, Fracture pattern, Fracture reduction, Implant design, Implant placement