Resection of the distal pole of the scaphoid for scaphoid nonunion with radioscaphoid and intercarpal arthritis1 ☆,
Section snippets
Patients and methods
Since 1997 our facilities have treated 11 patients with symptomatic scaphoid nonunion associated either radioscaphoid or intercarpal degenerative changes and carpal malalignment with resection of the distal pole of the scaphoid. Of these 11 patients 9 (8 men and 1 woman) who were monitored for more than 1 year were included in the present study. One of the excluded 2 patients was within 1 year from surgery and 1 failed to continue the follow-up evaluation. The average age of our subjects was
Results
The patients’ clinical assessments are summarized in Table 2. Seven patients reported pain with daily use and the remaining 2 patients reported mild pain with light work before surgery whereas after surgery 4 of the 9 patients had no wrist pain and the remaining 5 patients had only mild pain with strenuous activity. All patients returned to their preoperative jobs. The wrist range of motion improved in the flexion-extension arch from 70° ± 32° before surgery to 140° ± 21° after surgery (from
Discussion
Conventional bone grafting such as the Matti-Russe inlay graft technique has been described as the most common treatment of established scaphoid nonunion, with successful healing in 70% to 90% of cases.7, 8, 9 Scaphoid nonunion persisting after a failed previous bone graft or other procedure, however, still is clinically challenging. Several methods have been used to treat recalcitrant nonunions (those that do not improve after an initial surgical procedure), including repeat bone grafting,10
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Cited by (0)
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Supported in part by grants (no. 966007 and 016006) from the Central Research Institute of Fukuoka University, Fukuoka, Japan.
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No benefits in any form have been received or will be received by a commercial party related directly or indirectly to the subject of this article.