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Minerva Orthopedics 2022 October;73(5):445-50

DOI: 10.23736/S2784-8469.22.04204-3

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

Is adaptive proximal scaphoid implant (APSI) a valid option for SNAC wrist also in young patients?

Vincent J. MAZZONE 1, Marco D’ORIO 2 , Arturo MILITERNO 1, Federico TERRIBILE 3, Rocco DE VITIS 1

1 IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy; 2 Sacred Heart Catholic University, Rome, Italy; 3 Department of Orthopedics and Traumatology, Maggiore Hospital, Crema, Cremona, Italy



BACKGROUND: Adaptive proximal scaphoid implants (APSI) are an alternative treatment for patients with early scaphoid nonunion advanced collapse (SNAC) wrist. The purpose of this retrospective study was to analyze clinical and functional outcomes of APSI in functionally demanding patients, mostly treated between the third and the fourth decade of life.
METHODS: Twelve patients, under 53 years of age, who underwent an APSI procedure from January 2004 to June 2018 were included in the study. A clinical and radiographic assessment was performed using self-administered questionnaires, and ranges of motion (ROM) and grip strength were measured. The mean follow-up was 77.3±44.4 months, among them four patients with a follow-up greater than 9 years.
RESULTS: No complications were reported. The average VAS score was 0.5±0.9 at rest and 2.2±2.7 at stress. The mean percentage value of T-ROM was 73.3±8.2% compared with the healthy wrist. The mean grip strength percentage increased, compared with the contralateral grip, and was 80.2% for dominant and 67.9% for the non-dominant hands. The mean Mayo Wrist Score was 73.7, the mean DASH Score was 6.8.
CONCLUSIONS: This technique is an attractive, safe and valid treatment option for scaphoid proximal pole nonunion, also in young patients.


KEY WORDS: Wrist; Arthroplasty; Pyrolytic carbon

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