الفهرس 
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Abstract
Scaphoid non-union is challenging to manage because of the geometry of the scaphoid, the direction and type of fracture and the vascular pattern of the blood supply to the scaphoid. Thereafter this study was conducted to compare between usage of threaded Kirschner wires versus Herbert Screw in the management of non-union scaphoid fracture.
This was a prospective study including thirty patients aged between 15-40 years with isolated non-union scaphoid fracture in orthopedic department at MenoufiaUniversity Hospital and El Qabary Hospital at Alexandria from July 2019 to April 2021. The minimum following up period was six months after taking their consents.
Patients were divided randomly into two equal groups according to the fixation method with open reduction and iliac crest bone graft using volar approach to the scaphoid. group A: 15 patients treated by threaded k-wire, group B: 15 patients treated by Herbert screw.
These patients were assessed clinically according to the Modified Mayo wrist score, Quick DASH-9 and radiological assessment.
Union was achieved in 86.7% in group A while it was 100% in group B. The mean time from injury to surgery was 15.2 ± 6.89 (range, 7-30) months in group A while 13.67 ± 5.19 (range, 7-24) months in group B. The mean time from surgery to union was 10.92 ± 1.55 (range, 8-14) weeks in group A while 12.13 ± 1.77 (range, 10-16) weeks in group B. According to Modified Mayo score: the mean six months post-operatively was 81.67 ± 9.39 (range, 55-90) in group A while 82.67 ± 6.23 (range, 70-90) in group B. According to Quick DASH-9: the mean six months post-operatively was 25.67 ± 14.97 (range, 8-52) in group A while 23.93 ± 13.44 (range, 13-44) in group B. Four patients 26.7% (grade 1), nine 60% (grade 2), two 13.3% (grade 4) after six months post-operatively in group A while six patients 40% (grade 1), nine 60% (grade 2) after six months post-operatively in group B. Time to union was not affected by patient age, gender, smoking, side, type of non-union, site of fracture, mode of trauma or time to treatment.
Non-union after treatment occurred in two (6.7%) patients in group A. radiocarpal osteoarthritis was occurred in two (6.7%) patients in group A. wound dehiscence at site of iliac crest graft was occurred in one (3.3%) patient.