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Limited arthrodesis for scaphoid nonunion

S F Viegas1

  • 1Division of Orthopaedic Surgery, University of Texas Medical Branch, Galveston 77551.

The Journal of Hand Surgery
|January 1, 1994
PubMed
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This study introduces a novel surgical technique for chronic scaphoid nonunions, effectively fusing the wrist bones and relieving pain. The procedure offers significant pain relief and improved wrist function for patients with longstanding nonunions.

Area of Science:

  • Orthopedic Surgery
  • Hand Surgery
  • Biomechanics

Background:

  • Scaphoid nonunions with degenerative changes and carpal malalignment present complex treatment challenges.
  • Existing surgical options may not adequately address longstanding cases with established carpal instability.

Purpose of the Study:

  • To describe and evaluate a new surgical technique for treating chronic scaphoid nonunions with degenerative changes and carpal malalignment.
  • To assess the efficacy of this technique in achieving bony fusion, pain relief, and functional recovery.

Main Methods:

  • A novel surgical technique involving distal scaphoid fragment excision and limited wrist arthrodesis (proximal scaphoid, lunate, capitate) was developed.
  • Six male patients with symptomatic chronic scaphoid nonunions underwent the procedure.

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  • Outcomes including fusion rates, pain levels, and wrist range of motion were assessed.

    • Main Results:

    • All six patients achieved successful fusion of the limited arthrodesis.
    • Good to excellent pain relief was reported by all treated patients.
    • Average wrist range of motion was 50% compared to the contralateral side.

    Conclusions:

    • The described surgical technique is effective in treating longstanding scaphoid nonunions with degenerative changes and carpal malalignment.
    • This approach leads to successful bony fusion, significant pain reduction, and functional improvement.
    • It represents a viable option for complex scaphoid nonunion cases.