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Risk Factors That Cause Delayed Union after Surgery for Acute Scaphoid Fracture.

So Kawakita1, Kiyohito Naito1,2, Takamaru Suzuki1,2

  • 1Department of Orthopaedics, Juntendo University Faculty of Medicine, Tokyo, Japan.

The Journal of Hand Surgery Asian-Pacific Volume
|February 26, 2026
PubMed
Summary

Delayed union after scaphoid fracture surgery is linked to longer times from injury to treatment, humpback deformity, and wrist instability. Surgeons should consider these factors for better patient outcomes.

Keywords:
Delayed unionIntrascaphoid anglePercutaneous screw fixationScaphoid fractureScapholunate angle

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Area of Science:

  • Orthopedic Surgery
  • Traumatology
  • Radiology

Background:

  • Preventing delayed union in acute scaphoid fractures post-surgery is crucial.
  • Risk factors for delayed union after surgical intervention require further elucidation.
  • This study examines risk factors for delayed union in surgically treated scaphoid fractures.

Purpose of the Study:

  • To identify risk factors associated with delayed union in patients with acute scaphoid fractures.
  • To analyze the correlation between specific fracture characteristics and delayed union.
  • To provide clinical insights for surgeons managing scaphoid fractures.

Main Methods:

  • Retrospective analysis of 29 patients undergoing percutaneous screw fixation for scaphoid fractures.
  • Patients categorized into union (U) and delayed union (D) groups based on bone healing at 6 months.
  • Evaluation of factors including age, smoking, fracture classification, time to surgery, intrascaphoid angle (ISA), and scapholunate angle (SLA).

Main Results:

  • Delayed union occurred in 8 out of 29 cases.
  • Significant associations found between delayed union and: duration from injury to surgery (p=0.002), displacement (p=0.006), preoperative ISA (p<0.001), and preoperative SLA (p=0.008).
  • Positive correlations noted between preoperative ISA and time to surgery, and between preoperative ISA and preoperative SLA.

Conclusions:

  • Delayed union in scaphoid fractures is significantly associated with the duration from injury to surgery.
  • Humpback deformity (indicated by ISA) and wrist instability (indicated by SLA) are key factors contributing to delayed union.
  • These findings highlight the importance of timely surgical intervention and anatomical reduction for optimal scaphoid fracture healing.