[Pseudarthroses of the scaphoid and its surgical treatment]

Sclerotic bone ends and failure of union have quite often resulted from scaphoid fractures due to relatively insufficient blood supply to the proximal fragment. Clearly manifest scaphoid pseudarthrosis can be repaired only by surgery. Transplantation of cancellous or corticocancellous bone in combination with freshening of the sclerotic bone ends are priorities on which emphasis is laid in such surgical intervention. 38 patients with scaphoid pseudoarthrosis received surgical treatment in the casualty ward of Linz, between 1976 and 1982. The shortest follow-up interval for 30 patients was twelve months. 4 surgical methods were used, the technique of Streli in 16 cases, that of Matti-Russe in 9 instances, the Matti technique in 3 cases, and the Russe-II approach in 2 cases. Bony union was achieved in 90 per cent of the above patients. The technique of Streli was used in most cases for postoperative immobilisation, that is forearm cast for six weeks, which differed from other methods in which axilla to palm cast is applied up to twelve weeks. This paper has been prepared, with the view to describing results obtainable from various surgical approaches to scaphoid pseudoarthrosis.