Scaphoid Nonunion (Subscribe)  

In order to elucidate the history of scaphoid nonunion and to evaluate whether or not the problem has been solved, we have reviewed the literature from 1928 to 2003 for union rates, postoperative immobilization periods and complications of the different scaphoid bone grafting procedures. The outcomes of 5 246 scaphoid...

The purpose of this study was to analyze the relative bio- mechanical stability of three types of internal ixation with cancellous bone graft in a cadaveric, scaphoid nonunion model.
Comparison of fixation methods for scaphoid nonunions: a biomechanical model. Panchal A, Kubiak EN, Keshner M, Fulkerson E, Paksima N. Bull NYU Hosp Jt...

We report a preliminary study of a composite implant consisting of a biocoral frame, carrier collagen and bovine BMP in the treatment of scaphoid nonunions.
CONCLUSIONS: Only two wrists resulted in complete union. These preliminary results suggest that composite implant of BMP, as used in the present study, may not solve...

The authors compare the functional outcome of 8 patients treated by distal scaphoid resection arthroplasty for scaphoid nonunion with symptomatic wrist arthritis before surgery and after a minimum follow-up of 6 months. There was a significantly better range of radial deviation and grip strength at the time of re-examination. Significantly...

We randomly assigned 17 patients with scaphoid non-union at the proximal pole to three treatment groups: (1) autologous iliac graft (n=6), (2) autologous iliac graft + osteogenic protein-1 (OP-1; n=6), and (3) allogenic iliac graft + OP-1 (n=5). Radiographic, scintigraphic, and clinical assessments were performed throughout the follow-up period of...

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The purpose of this paper is to retrospectively review 234 consecutive cases of scaphoid fractures and nonunions treated using arthroscopy with the dorsal percutaneous implantation of a headless compression screw for healing and complications.
We conclude that the dorsal percutaneous treatment of scaphoid fractures and nonunions using arthroscopy is safe and...

Despite improvements in hardware and technique, nonunion may occur following open reduction and internal fixation of scaphoid fractures. Nonunion is most often related to preoperative (vascular), intraoperative (technical), or postoperative (compliance) issues. Untreated scaphoid nonunion is reported to result in a high incidence of posttraumatic arthritis ("SNAC Wrist"). Revision surgery...

The aim of the study was to investigate the effect of smoking on the operative treatment of established non-union of the carpal scaphoid. Case notes and radiographs of patients undergoing bone grafting and screw fixation of scaphoid non-unions were reviewed. There were 34 patients that had undergone 37 operations for...

The use of pedicled vascularised bone grafts from the distal radius makes it possible to transfer bone with a preserved circulation and viable osteoclasts and osteoblasts. Experiments performed at the basic science level has provided substantial evidence that low-intensity ultrasound can accelerate and augment the fracture healing process. Only an...

The nature and likelihood of later consequences of a fracture of the scaphoid depend upon the outcome of the fracture. For each outcome, one must consider the symptoms of the patient and the natural history of the fracture.
The late consequences of scaphoid fractures. Barton NJ. J Bone Joint Surg Br. 2004 Jul;86(5):626-30

One of the problems with scaphoid fractures is ischemia of the proximal fracture fragment resulting in delayed union, nonunion or irretrievable avascular necrosis. In this case, ischemic changes involving the entire scaphoid are documented following a scaphoid fracture due to minimal trauma. This progressed with cystic changes and AVN on...

A vascularised bone-graft procedure from the base of the second metacarpal was performed in 14 patients with nonunion of the scaphoid. There were 11 men and three women with a mean age of 22 years. In eight patients, who had dorsiflexed intercalated segment instability (DISI), an open wedge was formed...

Volar percutaneous cannulated screw fixation of acute scaphoid waist fractures reportedly produces high rates of healing and early return to work, but the method has not been reported for treating scaphoid waist delayed unions. We therefore report the surgical results of percutaneous screw fixation in scaphoid waist delayed union in...