Unstable Scaphoid Fracture Nonunion: A Medium-Term Study of Anterior Wedge Grafting Procedures

The Journal of Hand Surgery: British & European Volume - Tập 27 - Trang 36-41 - 2002
S EGGLI1, D.L FERNANDEZ1, T BECK1
1Department of Orthopeadic Surgery and Hand Unit, Lindenhofspital, Berne, Switzerland

Tóm tắt

A retrospective review of 37 patients with scaphoid fracture nonunions treated by interpositional bone grafting and internal fixation was conducted at an average follow-up of 5.7 years. Solid radiographic union was achieved in 35 cases. Preexisting avascular necrosis was a major adverse factor for achievement of union and satisfactory outcome. Based on the modified Mayo wrist-scoring system, 15 patients had an excellent result, 11 had a good result, four had a fair result and seven had a poor result. Patients with preexisting degenerative changes had a significantly worse clinical outcome. The vast majority of the patients had satisfactory correction of scaphoid length and the associated dorsal intercalated segment instability (DISI). Although 30 patients showed radiographic evidence of mild or moderate degenerative changes at their latest follow-up, there was no significant progression of arthrosis and the scaphoid nonunion advanced carpal collapse deformity did not progress after healing of the fracture nonunion.

Tài liệu tham khảo

10.1016/0363-5023(89)90191-3 10.1016/0266-7681(94)90081-7 10.2106/00004623-198971060-00007 10.1016/S0363-5023(88)80116-3 10.1302/0301-620X.78B4.0780530 10.1016/S0363-5023(84)80025-8 10.1016/S0363-5023(09)91122-4 10.2106/00004623-199506000-00009 10.1302/0301-620X.78B4.0780519 Fisk GR, 1980, Clinical Orthopedics and Related Research, 149, 137 Fisk GR, 1984, Journal of Bone and Joint Surgery, 66, 277 Herbert TJ, 1990, The Fractured Scaphoid 10.1302/0301-620X.79B3.0790418 10.1097/00003086-199710000-00019 10.2106/00004623-199274080-00012 10.2106/00004623-198668050-00003 10.1016/0363-5023(89)90127-5 10.1016/0266-7681(93)90114-U 10.2106/00004623-198567030-00013 10.1053/jhsu.1999.0430 10.1016/S0266-7681(98)80028-4 10.1097/00003086-199606000-00015 Steiger R, 1990, Handchirurgie Mikrochirurgie Plastische Chirurgie, 22, 152 10.1016/S0266-7681(05)80049-X
Thông tin
Thông tin xuất bản

The Journal of Hand Surgery: British & European Volume

Tập 27

36-41

Thông tin tác giả