Percutaneous Neutralization Screw with Arthroscopic Bone Grafting for Scaphoid Nonunion

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Arthroscopy

Background:

• Optimal management for established scaphoid nonunion remains debated.
• Key goals include restoring geometry, eliminating defects, ensuring stability for early mobilization, and achieving bone union.
• Current treatment modalities have limitations.

Purpose of the Study:

• To describe and evaluate a novel arthroscopic technique for scaphoid nonunion.
• To assess the efficacy of arthroscopic debridement, autologous bone grafting, and neutralization screw fixation.
• To compare this technique with existing treatment options.

Main Methods:

• A consecutive series of patients with scaphoid nonunion underwent arthroscopic assessment and debridement.
• Autologous cancellous bone grafting and fixation with a neutralization screw were performed.
• Pre- and postoperative assessments included range of motion and patient-reported outcome measures (VAS, QuickDASH).

Main Results:

• 13 out of 14 patients (93%) achieved union at a mean of 12.4 weeks.
• Significant improvements were observed in pain visual analogue scale (VAS) scores.
• Positive changes in range of motion and quick disabilities of the arm, shoulder, and hand (QuickDASH) scores were noted.

Conclusions:

• Arthroscopic management of scaphoid nonunion using a neutralization screw and bone graft is effective.
• This technique is simple, reproducible, and offers advantages over other treatments.
• It facilitates restoration of scaphoid geometry, stability, and union, leading to improved patient outcomes.