THE TREATMENT OF SCAPHOID NONUNION A review of a novel technique using precision bone grafting compared with Herbert screw fixation and bone traft

2000 ◽  
Vol 25 (5) ◽  
pp. 427-430
Author(s):  
N MARUTHAINAR
Keyword(s):  
Bone Grafting ◽  
Screw Fixation ◽  
Scaphoid Nonunion ◽  
Herbert Screw ◽  
Novel Technique

Factors Affecting the Outcome in 50 Cases of Scaphoid Nonunion Treated with Herbert Screw Fixation

1998 ◽  
Vol 23 (5) ◽  
pp. 680-685 ◽  
Author(s):  
J. SHAH ◽  
W. A. JONES
Keyword(s):  
Avascular Necrosis ◽  
Screw Fixation ◽  
Scaphoid Nonunion ◽  
Success Rates ◽  
Previous Surgery ◽  
Factors Affecting ◽  
Herbert Screw ◽  
Heterogeneous Nature ◽  
History Of

Our experience in the treatment of 50 scaphoid nonunions treated with Herbert screw fixation is reviewed. Success rates fell off as the duration of nonunion before treatment increased. However, this appeared to be related to the increased incidence of avascular necrosis with time rather than simply the factor of time alone. In this series the major adverse determinants for outcome were avascular necrosis and a history of previous surgery for nonunion. Failure to graft in a selected group with an intact cartilaginous envelope or a stable firm fibrous union did not affect results. The heterogeneous nature of any series of scaphoid nonunions is emphasized and the difficulties in comparing results with cohorts unmatched for the various adverse factors discussed is stressed.

scholarly journals Arthroscopic-assisted reduction, bone grafting and screw fixation across the scapholunate joint for proximal pole scaphoid nonunion

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Jung-Pan Wang ◽  
Hui-Kuang Huang ◽  
Jui-Tien Shih
Keyword(s):  
Fracture Healing ◽  
Grip Strength ◽  
Bone Grafting ◽  
Screw Fixation ◽  
Healing Time ◽  
The Body ◽  
Dash Score ◽  
Scaphoid Nonunion ◽  
Wrist Flexion ◽  
Radiographic Outcomes

Abstract Background There are some difficulties in treating proximal scaphoid nonunion, mainly including poor vascularity of the proximal scaphoid fragment and limited space for a stable fixation in the proximal scaphoid fragment. This study reports the outcomes of treating proximal scaphoid nonunion with arthroscopic assist for reduction, bone grafting and screw fixation across the scapholunate (SL) joint. Methods Between 2008 and 2017, 21 patients were enrolled. Fracture healing and change in the lateral SL angle and SL gap were evaluated. Functional outcomes were evaluated using the Disabilities of the Arm, Shoulder, and Hand (DASH) score, wrist range of motion, grip strength, and the Visual Analog Scale (VAS) for pain. Results Nineteen patients achieved fracture healing and their mean follow-up duration was 31.3 months (24–120 months). The average fracture healing time was 16.3 weeks (10 to 28 weeks). From the preoperative to the postoperative final evaluation, there was some significant improvement in wrist function, including wrist flexion from 54.5o to 67.4o, wrist extension from 62.3o to 71.7o, DASH scores from 52.4 to 21.4, VAS during activity from 4.6 to 2.1, and grip strength from 9.6 kg to 24.7 kg. The lateral SL angle also improved significantly, from 82o to 66o. Seventeen patients requested screw removal after fracture healing because of their cultural belief in not leaving hardware in the body. No significant SL gap widening was noted after screw removal in the sequential follow-ups. Conclusions Using arthroscopic-assisted reduction, bone grafting and screw fixation across the SL joint in proximal scaphoid nonunion treatment, satisfactory functional and radiographic outcomes can be achieved.

scholarly journals Functional outcome of scaphoid nonunion treated with herbert screw and bone grafting

2020 ◽  
Vol 6 (2) ◽  
pp. 97-102
Author(s):  
Bibin K Baby ◽  
◽  
Jyothish K ◽  
Aju T Thomas ◽  
◽  
...  
Keyword(s):  
Functional Outcome ◽  
Bone Grafting ◽  
Scaphoid Nonunion ◽  
Herbert Screw

scholarly journals A Critical Appraisal of Vascularized Bone Grafting for Scaphoid Nonunion

2016 ◽  
Vol 06 (03) ◽  
pp. 251-257 ◽  
Author(s):  
Ram Alluri ◽  
Christine Yin ◽  
Matthew Iorio ◽  
Hyuma Leland ◽  
Wendy Mack ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bone Grafting ◽  
Screw Fixation ◽  
Kirschner Wire ◽  
Surgical Techniques ◽  
Scaphoid Nonunion ◽  
Patient Centered ◽  
Level Of Evidence ◽  
Revision Procedure ◽  
Vascularized Bone

Background Vascularized bone grafting (VBG) has the potential to yield reliable results in scaphoid nonunion; however, results across studies have been highly variable. This study critically evaluates surgical techniques, fracture location, and patient selection in relation to radiographic, clinical, and patient-centered outcomes after VBG for scaphoid nonunion. Methods We conducted a systematic review of the literature for the use of VBG in scaphoid nonunion. Physical examination, radiographic, and patient-centered outcomes were assessed. Four substratifications were performed: the location of scaphoid nonunion, pedicled versus free technique, Kirschner wire (K-wire) versus screw fixation, and VBG done as a primary versus revision procedure. Results A total of 41 publications were included in final analysis. VBG had an 84.7% union rate at 13 weeks after surgery. On an average, 89% of patients returned to preinjury activity levels by 18 weeks after surgery and 91% of patients reported satisfaction with the procedure. Proximal pole nonunions demonstrated similar union rates but lower functionality scores compared with nonunions across all regions of the scaphoid. Pedicled techniques demonstrated slightly improved range of motion compared with free technique. K-wire versus screw fixation demonstrated significantly higher union rates and faster union times. There were no differences in outcomes for VBG done as a primary versus revision procedure. Conclusion VBG serves as a viable option for the treatment of scaphoid nonunion, with consistent union rates in addition to significantly improved postoperative patient functionality. The fixation of these vascularized bone grafts with K-wires versus screw fixation may result in superior radiologic outcomes. Level of Evidence Therapeutic, Level III, systematic review.

Scaphoid Nonunion: Herbert Screw Fixation through Dorsal Approach

2013 ◽  
Vol 18 (2) ◽  
pp. 49 ◽  
Author(s):  
Sang Hyun Lee ◽  
Jong Seok Oh ◽  
Chang Hyo Seo ◽  
Yong Jin Kim
Keyword(s):  
Screw Fixation ◽  
Scaphoid Nonunion ◽  
Dorsal Approach ◽  
Herbert Screw
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