Long-term outcome of scaphoid nonunion treated by the Matti-Russe operation

Background. This article presents the results of scaphoid non-union treatment using the Matti-Russe operation. The long-term outcome was compared in patients with bone union and patients with persistent nonunion. Materials and methods. We analyzed 81 cases (80 men, 1 woman) retrospectively. The end point was bone union or persistence of non-union. A long-term follow-up examination was done in 21 patients, with a follow-up ranging from 2 to 27 years (mean 8.8 years). Grip strength was measured with a dynamometer, range of movement was assessed, and the PRWE and DASH scales were used. Radiograms were evaluated for bone union, presence of osteoarthritis and radiolunate angle. Results. Bone union was achieved in 53 patients, persistent nonunion was observed in 23 patients (5 patients presented inadequate data for valid analysis). The long-term outcome was analyzed in 21 patients (14 with bone union and 7 with persistent nonunion). Better results based on subjective patient-rated scales were noticed in the group of bone union (PRWE 14.8, DASH 43.1) than in the non-union group (PRWE 30, DASH 61.8). Grip strength and range of movement were similar. The mean radiolunate angle was 9.6 in the bone union group, and 17.9 in the non-union group. Conclusions. The non-union ratio after Matti-Russe surgery was 28%. Grip strength and range of movement were similar in both groups. The results of the PRWE and DASH scales suggest better clinical outcome in patients with bone union.