[Osteosynthesis using a buttress plate--a new principle for stabilizing scaphoid pseudarthroses]

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Biomechanical Engineering

Background:

• Scaphoid pseudarthrosis often results in deformity and palmar bone resorption.
• A palmar wedge-shaped defect is a common consequence after pseudarthrosis treatment.
• Existing treatments may require specific graft types to ensure stability.

Purpose of the Study:

• To evaluate the efficacy of palmar buttress plate osteosynthesis combined with cancellous bone grafting for scaphoid pseudarthrosis.
• To assess the biomechanical advantages of palmar buttress plating in neutralizing forces.
• To determine the clinical outcomes, including union rates, pain, and functional recovery.

Main Methods:

• Retrospective analysis of 16 patients undergoing surgery for scaphoid pseudarthrosis.
• Surgical technique involved cancellous bone grafting and palmar buttress plate osteosynthesis.
• Follow-up examinations assessed union, pain levels, grip strength, and wrist mobility.

Main Results:

• Successful union of scaphoid pseudarthrosis in 15 out of 16 patients.
• All patients reported being pain-free at a minimum 9-month follow-up (mean 28 months).
• Minor reductions in grip strength and mobility were noted post-operatively. One patient experienced metal slackening and tendon rupture.

Conclusions:

• Palmar buttress plating provides biomechanically sound osteosynthesis, neutralizing forces effectively.
• This technique allows the use of pure cancellous bone grafts, enhancing stability and healing potential.
• Palmar buttress plating is a reliable surgical option for scaphoid pseudarthrosis, offering good functional outcomes.