DISI Deformity and Post-Operative Symptoms of Scaphoid Non-Union.

Area of Science:

• Orthopedic Surgery
• Hand and Wrist Surgery
• Musculoskeletal Research

Background:

• Scaphoid non-union is a common wrist injury often requiring surgical intervention.
• Residual dorsal intercalated segmental instability (DISI) deformity can occur after scaphoid fracture treatment.
• The relationship between DISI deformity and patient-reported outcomes following scaphoid non-union repair is not fully understood.

Purpose of the Study:

• To investigate the correlation between residual DISI deformity and post-operative wrist symptoms in patients treated for scaphoid non-union.
• To evaluate the impact of DISI deformity on range of motion, grip strength, and pain levels after surgical repair.

Main Methods:

• A cohort of 20 patients with healed scaphoid non-union, treated with open reduction and bone grafting, was retrospectively analyzed.
• Surgical techniques included modified Russe procedure and Herbert bone screw fixation.
• Post-operative assessments included range of motion, grip strength, pain evaluation, and radiographic analysis of DISI deformity.

Main Results:

• All 20 patients reported pre-operative wrist pain, with significant improvement post-surgery.
• Average wrist extension-flexion arc was reduced by 31 degrees compared to the uninjured wrist.
• Average grip strength was 89% of the uninjured wrist.
• Eight patients had residual DISI deformity, while 12 did not; no significant differences in post-operative range of motion, grip strength, or pain incidence were observed between these groups.

Conclusions:

• Residual DISI deformity following surgical repair of symptomatic scaphoid non-union is not predictive of post-operative wrist symptoms.
• Surgical intervention for scaphoid non-union effectively reduces pain and improves function, irrespective of residual DISI deformity.
• Further research may explore other factors influencing long-term outcomes in scaphoid non-union patients.