Avoiding Scaphoid Fracture Complications: Precision Fixation And Analysis of The Top 10 Global Herbert Screw Suppliers

Unique Anatomical Role of the Scaphoid

The scaphoid is the longest bone in the proximal carpal row, shaped like a small boat (hence the name “scaphoid”). It spans between the proximal and distal carpal rows, playing a key role in stabilizing and connecting both rows. Normal wrist motions, including flexion, extension, radial deviation, and ulnar deviation, all depend on the coordinated movement of the scaphoid. Once fractured, the biomechanics of the entire wrist joint are disrupted.

Fragile Vascular Supply

The scaphoid receives blood supply mainly from branches of the radial artery, entering from the dorsal ridge and distal pole:

• Approximately 70–80% of blood flow enters via the distal tubercle, flowing retrograde to nourish the proximal pole.

• Only a few branches directly enter the proximal pole.

• The closer the fracture is to the proximal pole, the greater the risk of vascular disruption.

• Once blood flow is interrupted, the proximal fragment is highly prone to AVN and nonunion.

Common Injury Mechanism

 The most common mechanism of injury is a fall onto an outstretched hand (FOOSH).When falling, individuals instinctively extend the arm and spread the fingers to absorb the impact with the palm. This frequent injury mechanism has drawn substantial clinical and research attention, and is widely referred to by the acronym FOOSH.

Key diagnostic recommendations:

• X-ray imaging should be performed for all wrist injuries, including scaphoid views when fracture is suspected.

• If X-rays are negative but suspicion remains, immobilization should be applied, followed by repeat imaging after 2 weeks.

• Early immobilization can serve as both a diagnostic and therapeutic measure.

Plaster Cast Immobilization:

Long-arm thumb spica cast:

• Indicated for proximal one-third fractures (highest AVN risk), vertical/oblique fracture lines, and initial diagnosis cases.

• Immobilizes elbow at 90°, forearm, wrist, and thumb.

• Provides maximum stability by eliminating forearm rotation.  

Short-arm thumb spica cast:

• Suitable for distal third fractures, tuberosity fractures, and stable mid-waist fractures (later stage).

• Offers more comfort but less stability.

Headless Compression Screw (Herbert Screw)

Currently the gold standard for scaphoid waist fractures.

• Principle: Inserted along the scaphoid axis under guidewire, providing interfragmentary compression.

• Advantages:

• Excellent compression across fracture line.

• High stability, allows early mobilization.

• Minimally invasive, percutaneous application possible.

• Low-profile, headless design reduces cartilage irritation.

• Approaches:

• Percutaneous: for stable, nondisplaced fractures.

• Open: for displaced, comminuted, or chronic fractures.

• Types:

• Headed compression screws.

• Headless compression screws (preferred, fully buried, less joint irritation).

Kirschner Wire (K-wire) Fixation

A traditional yet useful method, often adjunctive.

• Advantages: flexible, inexpensive, minimal disruption of vascularity.

• Disadvantages: less stable, requires external fixation, infection risk, removal needed post-healing..

• Indications: pediatric fractures, temporary fixation in comminution, adjunct to screw fixation.

Top 10 Herbert Screw Suppliers Worldwide

Rank	Company Name	Logo
1	DePuy Synthes
2	Stryker
3	Zimmer Biomet
4	Arthrex
5	Smith & Nephew
6	Wright Medical Group
7	Acumed
8	aap Implantate AG
9	Orthofix
10	CZMEDITECH

CZMEDITECH Herbert Screw Products

 As a leading Chinese manufacturer and supplier of orthopedic implants, CZMEDITECH provides a comprehensive portfolio of Herbert Screws tailored for scaphoid fractures and other small bone injuries.

Key Features:

• Headless compression design: ensures stable fixation while minimizing articular cartilage irritation.

• High biomechanical stability: reliable interfragmentary compression promotes solid union.

• Material options: available in medical-grade stainless steel and titanium alloy, with excellent biocompatibility and corrosion resistance.

• Minimally invasive compatibility: suitable for both percutaneous and open approaches.

• Multiple specifications: wide range of diameters and lengths to address diverse clinical needs.

Clinical Advantages:

• Facilitates rapid and reliable scaphoid fracture healing, especially in high-risk waist and proximal pole fractures.

• Enables early wrist mobilization, reducing stiffness and improving functional recovery.

• Significantly lowers risk of nonunion and AVN compared to traditional fixation methods.