Scaphoid Nonunion

The natural history and treatment of scaphoid fractures and subsequent nonunions have occupied a substantial portion of the orthopaedic literature. The authors examine the role of modern diagnostic tools in making an earlier diagnosis of scaphoid nonunion, in more accurately determining the displacement and angulation of the fragments, and in identifying the presence of avascular necrosis. They also consider the various available treatment modalities, including immobilization, electrical stimulation, both conventional and vascularized bone grafting, and internal fixation. Finally, a brief review of salvage procedures and the authors' preferred treatment are presented.