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Scaphoid nonunion.

A L Osterman1, M Mikulics

  • 1Department of Orthopaedics, Hospital of the University of Pennsylvania, Philadelphia.

Hand Clinics
|August 1, 1988
PubMed
Summary
This summary is machine-generated.

Scaphoid nonunion, a common wrist injury, often leads to arthritis. Treatment aims for bony healing, with bone grafting being a primary method, while salvage procedures address advanced cases with arthritis.

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Area of Science:

  • Orthopedic Surgery
  • Hand and Wrist Surgery
  • Traumatology

Background:

  • Scaphoid nonunion is a frequent complication of wrist fractures.
  • The precise pathophysiology remains unclear, with multiple contributing factors.
  • Delayed diagnosis and treatment can lead to progressive arthritis.

Purpose of the Study:

  • To review the pathophysiology, diagnosis, and treatment options for scaphoid nonunion.
  • To outline surgical techniques for achieving bony healing and managing advanced cases.

Main Methods:

  • Review of current literature on scaphoid nonunion.
  • Discussion of diagnostic modalities including radiography, instability testing, and arthroscopy.
  • Description of surgical treatments such as Russe bone grafting, Herbert screw fixation, radial styloidectomy, and wrist fusions.

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Main Results:

  • The Russe bone graft technique offers a high union rate (90%) for established nonunions without arthritis.
  • Internal fixation with Herbert screws and bone grafting may improve wrist motion and function.
  • Salvage procedures are necessary for scaphoid nonunion with degenerative arthritis, with varying outcomes.

Conclusions:

  • Prompt diagnosis and treatment are crucial to prevent arthritis following scaphoid nonunion.
  • Various surgical techniques exist, tailored to the specific stage and presentation of the nonunion.
  • Salvage procedures are essential for managing advanced scaphoid nonunion with arthritis, aiming to preserve function.