Repeat Russe bone grafting after failed bone graft surgery for scaphoid non-union

Area of Science:

• Orthopedic Surgery
• Bone Grafting Techniques
• Scaphoid Fracture Management

Background:

• Scaphoid non-union presents a significant challenge in orthopedic surgery.
• Repeat Russe bone grafting is an option after initial graft failure.
• Long-term outcomes of repeat grafting require further investigation.

Purpose of the Study:

• To evaluate the long-term outcomes of repeat Russe bone grafting for scaphoid non-union.
• To assess union rates, functional recovery, and patient satisfaction after revision surgery.
• To determine the efficacy of supplementary internal fixation in repeat grafting procedures.

Main Methods:

• A retrospective study of 15 patients undergoing repeat Russe bone grafting for scaphoid non-union.
• Patients were followed for a mean of 71 months post-operatively.
• Analysis of union rates, range of motion, grip strength, pain levels, and return to employment.

Main Results:

• Overall union rate was 53% (8/15) after one repeat graft and 25% (1/4) after a third attempt.
• In united cases, range of motion was preserved, grip strength improved by 10%, and pain was minimal.
• Seven of nine patients with achieved union returned to full employment.
• Non-union cases led to salvage procedures or consideration thereof.

Conclusions:

• Repeat Russe bone grafting can achieve satisfactory functional outcomes when union is obtained.
• The union rate of 53% without internal fixation suggests a need for improved techniques.
• Supplementary internal fixation is recommended for repeat Russe bone grafting to enhance union rates in scaphoid non-union treatment.