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Long-Term Outcomes of Scaphoid Malunion
Blake P Gillette1, Peter C Amadio1, Sanjeev Kakar1
1Mayo Clinic, Rochester, MN, USA.
Hand (New York, N.Y.)
|January 14, 2017
Summary
Long-term outcomes for scaphoid malunion treatments were similar, whether patients had surgery or nonoperative management. This study evaluated corrective osteotomy, salvage procedures, and nonoperative care over 30 years.
Area of Science:
- Orthopedics
- Hand Surgery
- Musculoskeletal Research
Background:
- Optimal treatment for scaphoid malunion is debated.
- Long-term results of surgical versus nonoperative management are not well-established.
Purpose of the Study:
- To evaluate long-term outcomes of operative and nonoperative treatments for scaphoid malunion.
- To compare corrective osteotomy, salvage procedures, and nonoperative management.
Main Methods:
- Retrospective review of scaphoid malunion cases over 30 years.
- Inclusion of patients undergoing corrective osteotomy, salvage procedures, or nonoperative care.
- Assessment using Mayo Wrist Score, Patient-Rated Wrist Evaluation (PRWE), and QuickDASH surveys.
Main Results:
- 17 patients with a mean follow-up of 21.4 years.
- Initial mean lateral intrascaphoid angle of 58°.
- Similar long-term PRWE and QuickDASH scores across corrective osteotomy (23, 6), salvage procedures (18, 10), and nonoperative management (33, 22).
Conclusions:
- Long-term functional outcomes for scaphoid malunion are comparable between surgical and nonoperative approaches.
- Both corrective osteotomy and salvage procedures showed similar long-term results to nonoperative management.
- Further research may be needed to guide specific treatment decisions.
