However, the detailed recovery course and the functional and radiographic outcomes of this approach are rarely reported in the literature. In comparison to percutaneous screw fixation and arthroscopic bone grafting, a combined volar and dorsal approach for bone grafting and screw fixation is thought to have inferior functional outcomes and prolonged recovery course because of the risks of a disrupted blood supply and scar formation.
Surgical procedures including bone graft and screw fixation are the gold standard treatments for scaphoid nonunion. Untreated scaphoid nonunion may progress to scaphoid nonunion advanced collapse, dorsal intercalated segment instability (DISI) deformity, and generalised wrist arthritis. The highest nonunion rate was 15.5% of scaphoid fracture amongst whole body bones. Scaphoid fracture accounts for 60% of all carpal fractures, and be the second most fractures around the wrists. The earliest recovered wrist functional parameters were grip strength, motion arc, Mayo Wrist score and finally the DASH score at postoperative 6 months and 12 months, respectively. The surgical outcomes for scaphoid nonunion treated with a combined volar bone grafting and dorsal antegrade headless screw achieved a high union rate, with great wrist functional and radiographic outcomes. Significant improvements were found in all scaphoid radiographic parameters. Compared to the preoperative status, the grip strength, wrist motion arc, and Mayo Wrist score were improved significantly 6 months after surgery, whilst the Disabilities of the Arm, Shoulder, and Hand (DASH) score did not recover until 12 months after surgery. ResultsĪll 18 patients achieved bone union at a mean time of 14.3 weeks.
#SCAPHOID FRACTURE SERIAL#
Preoperative and serial postoperative wrist functional and radiographic outcomes were collected and analysed. Material and methodsĮighteen patients with scaphoid nonunion who underwent combined volar bone grafting and dorsal antegrade headless screw fixation were enrolled in this retrospective study. The aim of this study was to investigate the recovery course and radiographic outcome for patients with scaphoid nonunion who underwent a combined volar bone grafting and dorsal antegrade headless screw approach. However, the detailed recovery course for this approach is rarely reported. Open surgery with a combined volar and dorsal approach is thought to have poor functional outcomes and a prolonged recovery course. Surgical treatment is necessary for scaphoid nonunion.
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