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Dorsal approach to scaphoid nonunion
H K Watson1, E C Pitts, D Ashmead
1Connecticut Combined Hand Service, Hartford Hospital, Conn.
The Journal of Hand Surgery
|March 1, 1993
Summary
This study found that a dorsal approach bone grafting technique effectively treated scaphoid nonunion, achieving high union rates and good functional recovery in patients. Most patients returned to their jobs after surgery.
Area of Science:
- Orthopedic Surgery
- Hand Surgery
- Traumatology
Background:
- Scaphoid nonunion is a common complication following wrist fractures.
- Surgical treatment often involves internal fixation with or without bone grafting.
Purpose of the Study:
- To evaluate the efficacy of a dorsal-approach bone grafting technique for scaphoid nonunion.
- To assess union rates, functional outcomes, and return to work.
Main Methods:
- Retrospective review of 36 patients undergoing dorsal-approach bone grafting for scaphoid nonunion.
- Fixation with Kirschner wires was used in all cases.
- Follow-up averaged 5 years.
Main Results:
- Achieved an 89% union rate.
- Average wrist flexion/extension was 76% of the contralateral wrist.
- Average grip strength was 88% of the contralateral hand.
- 91% of employed patients returned to their original jobs.
Conclusions:
- The dorsal approach offers satisfactory exposure for fragment reduction and bone grafting in scaphoid nonunion.
- This surgical technique yields high union rates and good functional recovery.