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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2022; 57(03): 437-442
DOI: 10.1055/s-0041-1724077
Artigo Original

Percutaneous Grafting and Screw Fixation in Patients with Scaphoid Nonunion[*]

Article in several languages: português | English
Muhittin Sener 
1   Departamento de Ortopedia e Traumatologia, Izmir Atatürk Training and Research Hospital, Izmir, Turquia
,
Eyup Cagatay Zengin 
2   Departamento de Ortopedia e Traumatologia, Gaziosmanpaşa Univercity, Tokat, Turquia
,
Sertac Saruhan 
3   Departamento de Ortopedia e Traumatologia, Izmir Bozyaka Training and Research Hospital, Izmir, Turquia
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Abstract

Objective The aim of the present study was to analyze the clinical and radiological results of patients with type-V cystic scaphoid nonunion who were treated with percutaneous grafting and screw.

Methods A total of 11 patients were treated with a percutaneous bone graft with screw fixation. The criteria for inclusion in the study were a type-V scaphoid nonunion and age > 18 years old. Those with humpback deformity, arthritis, ligament damage determined on magnetic resonance imaging, or avascular necrosis (AVN) in the nonunion fragment were excluded from the study.

Results The mean follow-up time was 36 months (range: 15–53 months). At the final follow-up examination, the mean visual analogue scale score was 1.06 (range: 0–2.3). Postoperatively, the mean extension was 61.6° (44–80°), flexion 66° (60–80°), radial deviation 12° (7–20°), and ulnar deviation 25° (20–34°). The mean grip strength of the operated hand was found to be 94%, compared with the healthy side. The results obtained in the Mayo Modified Wrist Score were poor in 2 patients, good in 2 and excellent in 7 (64%). With the exception of 2 patients, union was obtained radiologically in 9 patients, with a mean of 12.6 weeks (range, 8–16 weeks).

Conclusion Percutaneous grafting and screw fixation cannot replace open surgery in cases with deformity, shortening, humpbacking, or in long term nonunions; however, it is a reliable and effective treatment method in selected cases, such as Slade & Dodds type-V cystic nonunion.

Keywords

scaphoid bone - fracture fixation, internal - bone grafting - bone screws

Informed consent was obtained from all individual participants included in the study.

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The Ethical approval and grant number of the study is 14/11/2018–395.


Financial Support

There was no financial support from public, commercial, or non-profit sources.


* Work developed at Department of Orthopaedics and Traumatology, Izmir Atatürk Training and Research Hospital, Izmir, Turkey.




Publication History

Received: 08 June 2020

Accepted: 17 September 2020

Article published online:
19 April 2021

© 2021. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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