The Journal of hand surgery
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This prospective study reports on the use of the Herbert screw for fixation of fractures and nonunions of the scaphoid through a dorsal approach. In cases of delayed union and nonunion, screw fixation was combined with bone grafting. Twenty-five patients were treated in this manner, and union rates of 100% for acute fractures and 87% for delayed union and nonunion were achieved. We believe that the dorsal approach provides ready access to the scaphoid, enabling placement of the screw in the best possible position to provide fracture fixation.