Volar wedge grafting for scaphoid nonunion with collapse

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Bone Healing

Background:

• Scaphoid waist fractures are common and prone to nonunion.
• Untreated nonunion can result in a characteristic 'humpback deformity'.
• This deformity causes proximal carpal row collapse and dorsal lunate tilt, impairing wrist function.

Purpose of the Study:

• To describe the surgical technique for treating scaphoid nonunion with volar wedge grafting.
• To demonstrate how to restore scaphoid height and carpal alignment.

Main Methods:

• Surgical technique involving volar approach to the scaphoid.
• Insertion of a tricortical wedge graft harvested from the iliac crest.
• Correction of humpback deformity and restoration of carpal alignment.

Main Results:

• Volar wedge grafting effectively restores scaphoid height.
• Carpal alignment, including dorsal lunate tilt, can be corrected.
• The technique addresses the structural collapse associated with scaphoid nonunion.

Conclusions:

• Volar wedge grafting is a viable surgical option for scaphoid nonunion.
• This technique successfully corrects humpback deformity and carpal malalignment.
• Restoration of scaphoid anatomy improves overall wrist biomechanics.