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Corrective osteotomy for scaphoid malunion: technique and long-term follow-up evaluation
1Department of Orthopedics, Mayo Clinic, Rochester, MN 55905, USA.
The Journal of Hand Surgery
|January 1, 1997
Summary
Corrective osteotomy significantly improved wrist range of motion and grip strength in patients with symptomatic scaphoid malunion. This surgical intervention may help prevent or delay arthritis in young, active individuals.
Area of Science:
- Orthopedic Surgery
- Hand Surgery
- Wrist Biomechanics
Background:
- Scaphoid malunion can lead to dorsal intercalated segment instability (DISI) and wrist dysfunction.
- Symptomatic malunion often requires surgical correction to restore alignment and function.
Observation:
- Five patients with DISI secondary to scaphoid malunion underwent corrective osteotomy.
- Follow-up averaged nearly 9 years, assessing range of motion, grip strength, and wrist scores.
Findings:
- All patients demonstrated improved range of motion (127° to 156°) and grip strength (16 kg to 32 kg).
- Wrist scores improved significantly (19 to 75), and radiographic malalignments were corrected.
- Osteotomies healed successfully without avascular necrosis; mild arthrosis was noted in some patients.
Implications:
- Corrective osteotomy is an effective treatment for symptomatic scaphoid malunion, restoring wrist function.
- The procedure may play a role in preventing or slowing the progression of arthritis in young, high-demand patients.
- This technique offers a viable surgical option for complex wrist instability.