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Chirurgia 2020 December;33(6):289-94

DOI: 10.23736/S0394-9508.19.05068-X


language: English

Treatment of scaphoid nonunion with nonvascularized distal radius bone graft and headless cannulated compression screw

Kamil YAMAK 1 , Taşkin ALTAY 1, Fırat OZAN 2, Cemil KAYALI 1, Hüseyin G. KARAHAN 1

1 Department of Orthopedics and Traumatology, University of Health Sciences İzmir Bozyaka Education and Research Hospital, Izmir, Turkey; 2 Department of Orthopedics and Traumatology, Kayseri City Hospital, Kayseri, Turkey

BACKGROUND: The present study aimed to investigate the results of surgical treatment of scaphoid nonunion with nonvascularized distal radius bone graft.
METHODS: Between February 2012 and February 2016, a total of 36 patients surgically treated for scaphoid nonunion with nonvascularized distal radius bone graft and cannulated headless compression screws following open reduction were included. During follow-up, X-rays were taken for measurement of the scapholunate, lateral intrascaphoid, and radiolunate angles, the union status was evaluated, and the quick disabilities of the arm, shoulder and hand (QuickDASH) scores were used for measuring the pre- and postoperative outcome.
RESULTS: Mean age of patients was 30.8 years old. Mean period between trauma and surgery was 31.8 months. The distribution of study patients in accordance with the modified Herbert Classification was as follows; 17 (47.2%), 10 (27.8%), and 9 (25%) patients were type D2, D3, and D4, respectively. At the end of follow-up, union was encountered in 31 (86.1%) patients who were performed pseudarthrosis surgery with radius distal bone grafts. The period between trauma and surgery was longer in patients with avascular necrosis at the proximal pole (P=0.032). Presurgical QuickDASH scores showed improvement at the end of follow-up (P=0.001). X-ray angles measured before surgery and after follow-up were significantly different (P=0.001).
CONCLUSIONS: The present authors believe that nonvascularized distal radius bone grafts together with cannulated headless compression screws provide an efficient method in the surgical treatment of scaphoid nonunion.

KEY WORDS: Scaphoid bone; Osteonecrosis; Bone screw; Bone transplantation; Radius

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