Presentation
Chronic wrist pain and limitation of motion following a previous injury and surgical intervention.
Patient Data
The scaphoid bone has been excised with residual ill-defined bone fragments. There is intercarpal arthrodesis with two Herbert screws fixating the capitate-lunate and the triquetrum-hamate. There is near-total fusion/union of the arthrodesis.
There is a chronic non-united right scaphoid fracture with a fully threaded Herbert screw. Avascular necrosis of the proximal scaphoid cannot be excluded from the current study. The Herbert screw abuts the distal right radius with regional geodes suggesting developing radiocarpal OA.
Case Discussion
An example of a four-corner fusion in a patient with a chronic, non-united scaphoid fracture post previous trauma and operative management.
Herbert screws can be of two types:
headless fully threaded screw with 2 different pitches in each half (as demonstrated in the scaphoid fusion)
headless screw with cancellous and cortical threads at either end and a smooth non-threaded section in between (as demonstrated in the four-corner fusion)
Unable to process the form. Check for errors and try again.