Internal fixation of acute scaphoid fractures: a new approach to treatment.

Thirty-five patients with acute, unstable fractures of the scaphoid were treated by primary internal fixation using the Herbert Bone Screw System. The use of plaster was avoided whenever possible, and operation was carried out as soon as practicable after injury. The average time for return to work after operation was 3.7 weeks. Only one fracture failed to unite, and this was due to avascular necrosis of the proximal fragment of the scaphoid. Internal fixation of the acute scaphoid fracture successfully avoids the morbidity associated with standard methods of treatment in plaster.