Ideal Placement of the Herbert/Whipple Screw in Scaphoid Fracture: A Model Study

Yoo, Jae Doo; Kim, Jong Oh; Yun, Yeo Hon; Koh, Young Do; Bae, Su Young; Lee, Jeong Joon

Abstract

PURPOSE: To evaluate optimal placement of the Herbert/Whipple screw in scaphoid fracture.
MATERIALS AND METHODS
Forty eight models molded from four cadaver scaphoids were used for this study. Using the Herbert/Whipple jig, the guide wire was placed distal to proximal into each scaphoid with twelve method which were four entry points and three target points. Guide wire placement was then evaluated with three planes in the proximal, middle, distal planes and distance from the nearest cortex.
RESULTS
The most concentric position in the proximal plane was D5, in the middle plane C10. As distal entry point, the most concentric position in proximal plane was C. There were no statistical concentric, as middle, distal plane, and proximal entry point,
CONCLUSION
The most ideal placement were D5 in proximal fractures of the scaphoid, C5 in distal fractures. In waist fractures of the scaphoid, there were relatively safe, except A0 and D0. The position of entry points was more important than that of target points for ideal screw placement.