Clinical and Patient-Reported Outcomes After Hybrid Russe Procedure for Scaphoid Nonunion

Area of Science:

• Orthopedic Surgery
• Hand and Wrist Surgery
• Traumatology

Background:

• Scaphoid nonunion with humpback deformity presents a surgical challenge.
• The hybrid Russe technique is a described method for its treatment.
• Previous reports indicated a 100% union rate, necessitating reproducibility assessment.

Purpose of the Study:

• To evaluate the reproducibility and effectiveness of the hybrid Russe technique.
• To assess clinical and radiographic outcomes in patients with scaphoid nonunion and humpback deformity.

Main Methods:

• Retrospective chart review of 20 patients (21 nonunions) treated from 2015-2019.
• Minimum 3-month follow-up with radiographic and clinical outcome assessment.
• Primary outcome: scapholunate angle; Secondary outcomes: intrascaphoid angle, radiolunate angle, VAS pain, QuickDASH score, CT union, range of motion.

Main Results:

• A 95% union rate (20/21 scaphoids) was achieved on CT scans.
• Significant improvements in scapholunate (-17.6°), intrascaphoid (28.2°), and radiolunate (12.8°) angles.
• Mean VAS pain score improved by 6 points, and QuickDASH score by 10 points; 90% achieved symmetric range of motion.

Conclusions:

• The hybrid Russe technique demonstrates a high 95% union rate for scaphoid nonunion with humpback deformity.
• The technique is effective and reproducible, showing significant improvements in radiographic alignment and patient-reported outcomes.
• It serves as a viable alternative to techniques requiring structural bone grafts from other body sites.