| Scaphoid is the important part of the wrist, and the fracture of the scaphoid is one of the most common fractures of the carpal bones second only to fractures of distal radius for its special anatomical features of a dumbbell shape and the distinct location in carpal joints. In addition, the scaphoid has a peculiar and limited retrograde blood supply that is vulnerable to disruption by trauma; consequently, scaphoid fractures are prone to a high rate of delayed union and non-union if misdiagnosis or not treated properly, even leads to degenerative arthritis or instability of carpal joints,such as DISI and VISI. The studies of scaphoid fracture are mostly concentrating on two aspects, one is the utilize of new techniques such as CT, Bone Scanning, MRI, 3DCT and its elimination technique for improving diagnosing rate. The other is to treat scaphoid fractures with various kinds of modified screws, it is said that this method can reduce the time of immobilization. However, for the reason of high price and complicated skills, and not common approved by most scholars in the aspect of improving the union rate of fractures and the postoperative function of the wrist, the clinical application is not very popular ,especially in the developing countries such as in China. In contrast, the traditional method treating scaphoid fractures with Kirschner wire is still the first choice in many clinical units for its low price, simple procedure, and has the high postoperative union rate of fractures and excellent wrist functions. Our study is based on the 45 patients treated with K-wire in our department between 1999-2009.Among them 20 patients have been fully followed up and have the sufficient information for the healing of fractures and the functions of the wrist. we use the X-ray (including PA, lateral and Stecher views), CT, 3DCT and its elimination technique to evaluate the healing of the fractures.The assessment of the wrist functions includes four parts: the presence of pain, grip strength (proportion in the unaffected wrist), the ability to work and the range of the flexion-extention. Of the 20 patients, all have achieved bone union, but one with hump back deformity, the union rate is 100%. The assessments of the wrist function are satisfactory. Among them, 15 patients reported no pain in the wrist while 5 had occasional ache when exerting manual work. The grip strength is 69% of that in the contralateral wrist, the right handedness injured is 89.3%, the non right handedness injured is 46.3%. 9 patients have a normal wrist function in daily life,9 slightly restricted, while 2 obviously restricted. The range of flexion-extention are among 70°-166°, at an average of 114°. According to the improved Mayo assessment of the wrist function, there are 10 exellent, 2 good, 5 fair and 3 poor results, of the good and poor class, 6 are B4, according to the Herbert classification of the scaphoid. because of the severe injury of the soft tissue, and the coexist of other lesion, this type of fracture always have a bad postoperative wrist function. 2 are B2 fractures, between them, 1 patient preoperatively coexist fracture of 4,5 metacarpal bone, and there is a postoperative complication of adhesion of tendon,this cause the loss of the grip strength and the mobility range. The other patient did not obey to the doctors for personal reasons, and extend the immobilizating time to 4 months,in addition,the following time was 5 month postoperative. Analyzing our results, we conclude that treating scaphoid fractures with Kirchner wire has a high union rate of fractures and good function recovery of wrist, meanwhile it also has the advantages of convenient fixation, minimal invasion of the scaphoid blood supply and simple technique,low price et. Treating unstable scaphoid fractures of all kind with Kirchner-wire should be a practical choice with good results.
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