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Related Concept Videos

Bones of the Upper Limb: Radius01:09

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The radius is longer of the two bones that make up the human antebrachium or forearm. At the proximal end, the radius articulates with the capitulum of the humerus and the radial notch of the ulna to form the elbow joint. At the distal end, the radius articulates with the ulna via the ulnar notch, forming the distal radioulnar joint. Distally, the radius also attaches to the carpal wrist bones (scaphoid and lunate) to form the radiocarpal joint.
The radius has a nail-shaped head, and a...
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Anterior Capsular Reconstruction with Human Dermal Allograft for Irreparable Subscapularis Tears
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Scaphoid Reconstruction.

Cristian S Borges1, Paulo H Ruschel1, Milton B Pignataro1

  • 1Division of the Orthopedics and Traumatology Department, Santa Casa Hospital Complex, Porto Alegre, Brazil; Clinica da Mao ao Cotovelo, 569/601 Soledade Street, Porto Alegre, Rio Grande do Sul 90470-340, Brazil.

The Orthopedic Clinics of North America
|November 20, 2019
PubMed
Summary
This summary is machine-generated.

Surgical strategies for scaphoid nonunions depend on injury timing. Treatment options range from percutaneous screw fixation for recent injuries to bone grafting or salvage procedures for chronic cases.

Keywords:
Bone graftBone reconstructionNonunionSNAC wristScaphoid

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Area of Science:

  • Orthopedic Surgery
  • Hand Surgery
  • Traumatology

Background:

  • Scaphoid nonunions present complex surgical challenges.
  • Treatment decisions are influenced by the time elapsed since injury and the presence of carpal malalignment.

Purpose of the Study:

  • To outline a logical decision-making sequence for surgical management of scaphoid nonunions.
  • To present evidence-based treatment strategies tailored to different stages and severities of scaphoid nonunion.

Main Methods:

  • Review of surgical strategies for scaphoid nonunions based on chronicity and associated pathologies.
  • Discussion of treatment options including percutaneous fixation, vascularized bone grafts, distal pole resection, and proximal row carpectomy.

Main Results:

  • Early scaphoid nonunions (<1 year) without carpal malalignment are amenable to percutaneous screw fixation.
  • Pedicle vascularized bone grafts are effective for reinterventions or avascular proximal poles.
  • Distal pole resection is suitable for old nonunions or post-failed procedures.
  • Proximal row carpectomy is indicated for radioscaphoid degenerative changes.

Conclusions:

  • A structured approach to scaphoid nonunion treatment optimizes outcomes.
  • Treatment selection should be guided by injury chronicity, avascularity, and degenerative changes.