The Adaptive Proximal Scaphoid Implant: Long-Term Follow-Up

Scaphoid proximal pole fracture with avascular necrosis is a surgical challenge, particularly in patients with high functional demand. An option is the pyrocarbon adaptive proximal scaphoid implant (APSI), replacing the necrotic proximal pole.

A long-term follow-up study of the early cases treated in our department was conducted. Thirty-six patients with a median follow-up time of 19 years (range, 11-25) were included in the analysis, performing clinical and radiological evaluations.

Clinically, significant improvements were observed in mean pain Numeric Rating Scale (from 6.8 [SD 2.1] to 2 [2]), range of motion, grip strength measured with the Jamar dynamometer (from 18 [8] kg to 24 [9] kg), Disabilities of the Arm, Shoulder, and Hand score (from 66 [6.5] to 13.7 [6.4]), and Patient-Rated Wrist Evaluation score (from 73 [10] to 28 [12]). Radiographs showed good implant stability. No patient required implant removal.

The APSI prosthesis proves effective long term in relieving pain, improving function, and preventing carpal collapse through stable biomechanical integration.