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Soft tissue interposition arthroplasty for scaphoid nonunion.

M E Boeckstyns, L Kjäer, P Busch

    The Journal of Hand Surgery
    |January 1, 1985
    PubMed
    Summary
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    Long-term follow-up of scaphoid nonunion patients showed high satisfaction despite some pain and reduced wrist function. Degenerative changes like osteoarthritis were minimal, even with carpal collapse.

    Area of Science:

    • Orthopedic surgery
    • Hand surgery
    • Musculoskeletal research

    Background:

    • Scaphoid nonunion is a common complication following wrist fractures.
    • Bentzon's soft tissue interposition arthroplasty is a surgical technique for treating scaphoid nonunion.
    • Long-term outcomes of this procedure are not well-documented.

    Purpose of the Study:

    • To evaluate the long-term outcomes of Bentzon's soft tissue interposition arthroplasty for scaphoid nonunion.
    • To assess patient satisfaction, wrist function, and the development of degenerative changes over time.

    Main Methods:

    • Retrospective study of 26 patients undergoing Bentzon's arthroplasty for scaphoid nonunion.
    • Follow-up examination 22 to 39 years post-surgery.
    • Assessment of patient-reported outcomes, wrist mobility, grip strength, and radiographic findings (nonunion, carpal collapse, osteoarthritis).

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    Main Results:

    • High patient satisfaction (25/26) reported, with only three experiencing moderate pain.
    • Significant reductions in wrist mobility (20-25%) and grip strength (8%) were observed.
    • Radiographic nonunion persisted in 16/25 cases; carpal collapse increased over time in 15 cases.
    • Osteoarthritis developed in 5/15 wrists with carpal collapse and 2/10 without; no significant osteoarthritis before 27 years post-op.

    Conclusions:

    • Bentzon's soft tissue interposition arthroplasty provides good long-term patient satisfaction for scaphoid nonunion.
    • While functional deficits and radiographic instability can persist, the risk of significant disability from late degenerative changes is low.