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Arthroscopic Bone Grafting in Scaphoid Nonunion
Jeffrey Justin Siu-Cheong Koo1, Pak-Cheong Ho2
1Department of Orthopaedics and Traumatology, Alice Ho Miu Ling Nethersole Hospital, Hong Kong SAR, Hong Kong.
Journal of Wrist Surgery
|January 23, 2026
Summary
Arthroscopic bone grafting effectively treats scaphoid nonunion, achieving a 90.3% union rate. This minimally invasive technique offers a favorable biological environment for healing, making it a preferred method for complex wrist fractures.
Area of Science:
- Orthopedic surgery
- Hand and wrist surgery
- Arthroscopy
Background:
- Scaphoid nonunion presents a significant challenge in fracture management.
- Conventional open techniques risk damage to vascularity and ligaments.
- Advancements in wrist arthroscopy have led to arthroscopic bone grafting for scaphoid nonunion.
Purpose of the Study:
- To evaluate the efficacy of arthroscopic bone grafting for scaphoid nonunion.
- To assess the union rate and clinical outcomes of this minimally invasive procedure.
Main Methods:
- 111 scaphoid nonunion and 14 delayed union cases were operated on between 1997 and 2016.
- Nonunion sites were debrided via the Midcarpal Radial (MCR) portal.
- Autologous bone grafts were packed into the defect, and fragments were fixed percutaneously.
Main Results:
- Overall bone union was achieved in 90.3% of cases, with an average healing time of 14 weeks.
- Fourteen cases failed to achieve union.
- Poor bleeding from the proximal scaphoid fragment was the only statistically significant factor negatively impacting union rate (78.8%).
Conclusions:
- Arthroscopic bone grafting is a breakthrough treatment for scaphoid delayed and nonunion.
- The procedure offers a favorable biological environment, leading to high union rates and satisfactory outcomes.
- Minimally invasive arthroscopic approach improves scaphoid fracture management.
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