الفهرس 
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Abstract
The scaphoid bone has an oblique orientation and bridges the distal and proximal carpal rows on the radial side.
It is well reported that some fractures may be imperceptible on initial radiographs, the so-called occult fracture. A meta-analysis has suggested that 16% of scaphoid fractures may initially be radiographically occult.
Fractures of the scaphoid result in uneventful bony healing in 90-95% of patients. Nevertheless, nonunion occurs in a significant number of patients, even when the injury is promptly recognized and appropriately treated .
About 5% of scaphoid fractures do not unite and non-union is most often defined as absence of union on radiographs six months after injury .
The diagnosis of non-union is usually made on plain radiographs. Displacement of fracture fragments, a clear gap, cyst formation, and sclerosis all suggest non-union. These features may take several months to appear .
Untreated scaphoid non-union leads to arthritis accompanied by pain, weakness, and restriction of wrist motion.
Screw fixation with non-vascularized bone grafting is the most widely used procedure for delayed union and non-union of scaphoid fractures.
The Herbert screw is designed to produce compression and rigid fixation of small cancellous bone fragments in scaphoid fracture . It allows early mobilisation of the wrist and hand; complications associated with prolonged immobilisation in plaster cast are thus avoided. As the screw head is replaced by a threaded end, the screw can be completely buried in the bone .
The main aim of this study was mainly to evaluate efficiency of Herbert screw in fixation of non united scaphoid and to assess rates of union while using Herbert screw.
This study included 10 patients represented by 8 males (80%) and 2 females (20%). Their age ranged from 18-28 years, with average age of 24 years. All patients gave history of trauma with average duration of presentation of 11.9 months (range from 6 to 16 months).The union rate in this study was 60% since 6 patients were united while 4 were not united.
In summary, a combination of thorough curettage of unhealthy bone, impaction of cancellous bone graft, and internal rigid fixation with Herbert’s screw provides a good option for treatment of scaphoid nonunion. This procedure provides sustained rebuilding of scaphoid length, correction of any deformity, avoidance of further collapse, and leads to promising bony union.