Arthroscopy Treatment of Scaphoid Pseudarthrosis: Description of the Technique and Case Series

Objective  To describe the procedure and evaluate the results of a series of patients with stable and unstable pseudarthrosis of the scaphoids treated with the use of arthroscopy associated with cancellous bone graft and compression screw. Methods  Twenty-three patients were treated with this technique. The minimum postoperative follow-up was 12 months, and pre- and postoperative functional, clinical, and imaging analyses were performed. Results  Themean time from fracture to surgery was 26 months (12-60). Preoperative and postoperative clinical and radiological parameters were analyzed. The mean follow-up was 24.2 (12-60) months. Consolidation occurred in 22 patients (95.6%) in an average of 7.5 (4-12) weeks. Mean flexion range ofmotion improved from73.6° (60-80°) to 79.5° (60-90°); the range from 68.6° (50-80°) to 71.9° (45-85°); ulnar deviation from 20.6° (15-30°) to 26.9° (20-35°); and the radial deviation from 17.3° (15-25°) to 20.4° (10-25°). Pain (Visual Analog Scale [VAS] 0-10) improved from 7.3 (4-9) to 0.7 (0-6) and DASH functional scale improved from 49 (32-75) to 6 (2-12). The scapholunate angle improved from 69.1° (55-85°) to 48.4° (40-55°) and the radiolunar angle improved from 30° (10-40°) to 2.6° (0-8°). Conclusion  Treatment of stable and unstable pseudarthrosis of the scaphoid with spongy bone graft and percutaneous internal fixation, preferably with a headless compression screw, assisted by arthroscopy, showed good clinical and radiographic results in our series, with a short time for consolidation and functional recovery.