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Arthroscopic-Assisted Scaphoid Nonunion Repair.

Tim J Westbrooks1, Anna L Gorsky1, Nina Suh1

  • 1Department of Orthopaedic Surgery, Emory University School of Medicine, Atlanta, GA.

The Journal of Hand Surgery
|February 26, 2026
PubMed
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Arthroscopic-assisted scaphoid nonunion repair offers a minimally invasive solution for wrist fractures. This technique preserves soft tissues, enabling effective debridement, bone grafting, and fixation for improved healing and wrist function.

Area of Science:

  • Orthopedic Surgery
  • Hand and Wrist Surgery
  • Arthroscopy

Background:

  • Scaphoid fractures are common carpal injuries with a high risk of nonunion, potentially leading to wrist arthritis.
  • Traditional open repair can compromise vascularity and increase stiffness due to extensive dissection.
  • Arthroscopic techniques offer an alternative to preserve soft tissues and visualize pathology.

Purpose of the Study:

  • To describe a reproducible arthroscopic-assisted technique for scaphoid nonunion repair.
  • To detail the use of percutaneous autologous distal radius bone grafting and headless compression screw fixation.
  • To highlight the advantages of arthroscopic repair over traditional open methods.

Main Methods:

  • Diagnostic wrist arthroscopy followed by debridement of the nonunion site via midcarpal portals.
Keywords:
Arthroscopynonunionscaphoid

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  • Percutaneous harvesting of autologous cancellous bone graft from the distal radius.
  • Arthroscopic introduction of bone graft and fixation with headless compression screws, followed by graft augmentation and fibrin sealant.

    • Main Results:

    • Arthroscopic repair allows for complete debridement, precise reduction, and biologically favorable bone grafting.
    • Preservation of scaphoid vascularity and ligamentous structures.
    • Reported union rates and clinical outcomes comparable to open surgery, with reduced donor site morbidity and maintained wrist motion.

    Conclusions:

    • Arthroscopic-assisted scaphoid nonunion repair is a reliable and biologically sound technique.
    • It offers advantages in visualization, reduced morbidity, and preservation of wrist motion.
    • This method provides an effective option for managing scaphoid nonunions.