Impact of scaphoid non-union characteristics on healing outcomes

Scaphoid non-union remains a challenging clinical condition with the potential to result in long-term functional impairment. Identifying predictive factors for postoperative healing could improve treatment strategies and patient counselling. This study aimed to evaluate the potential impact of specific scaphoid non-union characteristics on healing time and the risk of persistent non-union following surgical intervention.

We retrospectively analyzed 100 cases of surgically treated scaphoid non-unions between 2002 and 2020. The presence of scaphoid height difference, defect zone, and lateral intrascaphoid angle (LISA) and coronal intrascaphoidal angle (CISA) was documented. To determine associations with time to union and persistent non-union statistical testing used Mann-Whitney U, Spearman rank correlation, or Fisher's exact test as appropriate. Multivariate linear regression was performed, and p-values were Bonferroni-corrected.

Of the 100 cases, 90 healed uneventfully, while 10 demonstrated persistent non-union at final follow-up. The median healing time was 73 days (interquartile range: 57-111 days). No statistically significant association was found between the assessed characteristics-scaphoid height difference, defect zone, LISA or CISA-and either time to union or persistent non-union.

Our findings suggest that the four principal radiographic characteristics of scaphoid non-union do not significantly influence postoperative healing. These features may therefore be considered negligible in the prognostic assessment of surgical outcomes, supporting a more streamlined approach to preoperative evaluation.