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Arthroscopic reconstruction for unstable scaphoid non-union
P J Delgado-Serrano1, I Jiménez-Jiménez1, M Nikolaev1
1Unidad de Cirugía de la Mano y Microcirugía, Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario HM Montepríncipe, Universidad San Pablo CEU, Boadilla del Monte, Madrid, España.
Summary
Arthroscopic reconstruction using cancellous bone graft effectively treats unstable scaphoid non-union. This minimally invasive approach leads to rapid bone consolidation and significant improvements in wrist function and pain relief.
Area of Science:
- Orthopedic Surgery
- Hand Surgery
- Arthroscopy
Background:
- Scaphoid non-union, particularly unstable types, presents a significant challenge in hand surgery.
- Traditional treatments may involve open procedures with varying success rates and complication profiles.
Purpose of the Study:
- To evaluate the efficacy of arthroscopic reconstruction with cancellous bone autograft for unstable scaphoid non-union.
- To assess clinical and radiological outcomes following this minimally invasive surgical technique.
Main Methods:
- A cohort of 13 patients with unstable scaphoid non-union underwent arthroscopic reconstruction using cancellous bone autograft.
- Preoperative and postoperative clinical assessments (range of motion, pain via VAS, DASH questionnaire) and radiological evaluations (Scapho-Lunate Angle, Radio-Lunate Angle) were performed.
- Mean follow-up was 16.8 months.
Main Results:
- All 13 patients achieved bone consolidation within an average of 7 weeks, with no reported complications or need for reoperation.
- Significant improvements were observed in wrist range of motion, reduction in pain (VAS score decreased from 6.8 to 0.7), and functional capacity (DASH score improved from 36 to 8).
- Radiological parameters, including the Scapho-Lunate Angle and Radio-Lunate Angle, demonstrated significant improvement, indicating restored wrist biomechanics.
Conclusions:
- Arthroscopic reconstruction with cancellous bone autograft is a safe and effective treatment for unstable scaphoid non-union.
- The procedure offers favorable clinical outcomes, characterized by a short consolidation period and rapid recovery.
- Minimally invasive arthroscopic techniques provide a valuable alternative for managing complex scaphoid fractures.
