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Management of scaphoid nonunions
Thanapong Waitayawinyu1, H James Pfaeffle, Wren V McCallister
1Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, WA 98195-4743, USA.
Hand Clinics
|December 17, 2009
Summary
Scaphoid nonunions, often with deformity or avascular necrosis, require surgical correction. Treatment involves open reduction, internal fixation, bone grafting, and vascularized grafts for necrosis.
Area of Science:
- Orthopedic surgery
- Radiology
- Bone healing
Background:
- Scaphoid nonunions present with or without proximal pole avascular necrosis.
- Waist fractures can lead to humpback deformity.
Purpose of the Study:
- To outline diagnostic imaging and surgical management strategies for scaphoid nonunions.
- To differentiate imaging modalities for assessing deformity and avascular necrosis.
Main Methods:
- Computed Tomography (CT) for evaluating deformity and bone loss.
- Magnetic Resonance Imaging (MRI) for detecting avascular necrosis.
Main Results:
- CT effectively visualizes scaphoid deformity and bone loss.
- MRI is superior for identifying avascular necrosis of the proximal pole.
Conclusions:
- Surgical correction of scaphoid nonunion involves open reduction, internal fixation, and bone grafting.
- Vascularized bone grafts are indicated for scaphoid nonunions with avascular necrosis.
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