Skip to main content
SpringerLink
Log in

Scaphoid Nonunion: Surgical Fixation with Local Nonvascularized Bone Graft (Open)

  • Chapter
  • First Online:
Scaphoid Fractures and Nonunions

  • 1489 Accesses

Abstract

A healthy, 20-year-old right-hand dominant collegiate student athlete presented with a chief complaint of persistent left wrist pain. Three months prior to his presentation, the patient recalled falling awkwardly and landing on an outstretched and hyperextended left wrist during a sporting event. The patient reported persistent pain and limited wrist range of motion, particularly in dorsiflexion. On physical examination, the patient was in mild distress secondary to left wrist discomfort. He was otherwise a well developed and healthy individual standing 190 cm tall and weighing 88 kg. Neck, shoulder, elbow, and digital range of motion were equal, symmetric, and painless.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Kawamura K, Chung K. Treatment of scaphoid fractures and nonunions. J Hand Surg 2008;33A:988–97.

    Article  Google Scholar 

  2. Langhoff O, Andersen JL. Consequences of late immobilization of scaphoid fractures. J Hand Surg [Br]. 1988;13:77–9.

    Article  CAS  Google Scholar 

  3. Schuind F, Haentjens P, Van Innis F, Vander Maren C, Garcia-Elias M, Sennwald G. Prognostic factors in the treatment of carpal scaphoid nonunions. J Hand Surg. 1999;24A:761–76.

    Article  Google Scholar 

  4. Ruby L, Stinson J, Belsky M. The natural history of scaphoid non-union: a review of fifty-five cases. J Bone Jt Surg. 1985;67-A:428–32.

    Article  Google Scholar 

  5. Gelberman R, Menon J. The vascularity of the scaphoid bone. J Hand Surg. 1980;5:508–13.

    Article  CAS  Google Scholar 

  6. Waitayawinyu T, McCallister WV, Nemechek NM, Trumble TE. Surgical techniques: scaphoid nonunion. J Am Acad Orhop Surg. 2007;15:308–20.

    Article  Google Scholar 

  7. Bindra R, Bednar M, Light T. Volar wedge grafting for scaphoid nonunion with collapse. J Hand Surg. 2008:33A:974–9.

    Article  Google Scholar 

  8. Ribak S, Medina C, Mattar R, Ulson H, de Resende M, Etchebehere M. Treatment of scaphoid nonunion with vascularized and nonvascularized dorsal bone grafting from the distal radius. Int Orthop. 2010;34:683–8.

    Article  PubMed  Google Scholar 

  9. Green DP. The effect of avascular necrosis on russe bone grafting for scaphoid nonunion. J Hand Surg. 1985;10A:597–605.

    Article  Google Scholar 

  10. Braga-Silva J, Peruchi FM, Moschen GM, Gehlen D, Padoin AV. A comparison of the use of distal radius vascularized bone graft and non-vascularized iliac crest bone graft in the treatment of non-union of scaphoid fractures. J Hand Surg. 2008;33E:636–40.

    Article  Google Scholar 

  11. Bruno RJ, Cohen MS, Berzins A, Sumner DR. Bone graft harvesting from the distal radius, olecranon, and iliac crest: a quantitative analysis. J Hand Surg. 2001;26A:135–41.

    Article  Google Scholar 

  12. Fisk GR. Volar wedge grafting of the carpal scaphoid in non-union associated with dorsal instability patterns (discussion). proceedings of seventh combined meeting of the orthopaedic associations of the english speaking world, Cape Town, South Africa, March, 1982. J Bone JT Surg [Br]. 1982;64:632–3.

    Google Scholar 

  13. Andrews J, Miller G, Haddad R. Treatment of scaphoid nonunion by volar inlay distal radius bone graft. J Hand Surg. 1985;10B:214–6.

    Article  Google Scholar 

  14. Goyal T, Sankineani SR, Tripathy SK. Local distal radius bone graft versus iliac crest bone graft for scaphoid nonunion: a comparative study. Musculoskelet Surg. 2013;97(2):109–14.

    Article  CAS  PubMed  Google Scholar 

  15. Tambe AD, Cutler L, Stilwell J, Murali SR, Trail IA, Stanley JK. Scaphoid non-union: the role of vascularized grafting in recalcitrant non-unions of the scaphoid. J Hand Surg. 2006;31B:185–190.

    Article  Google Scholar 

  16. Merrell GA, Wolfe SW, Slade JF III. Treatment of scaphoid non-unions: quantitative meta-analysis of the literature. J Hand Surg. 2002;27A:685–91.

    Article  Google Scholar 

  17. Monreal R. Treatment of scaphoid nonunions with closed-wedge osteotomy of the distal radius: report of six cases. Hand. 2008;3:91–5.

    Article  PubMed  Google Scholar 

  18. Russe O. Fracture of the carpal navicular. Diagnosis, non-operative treatment, and operative treatment. J Bone Jt Surg. 1960;42A:759–68.

    Article  Google Scholar 

  19. Zoubos AB, Triantafyllopoulos IK, Babis GC, Soucacos PN. Modified matti-russe technique for the treatment of scaphoid waist non-union and pseudoarthrosis. Med Sci Monit. 2011;17(2):MT7–12.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Hagert, E, Ferreres A, Garcia-Elias M. Nerve-sparing dorsal and volar approaches to the radiocarpal joint. J Hand Surg. 2010;35(7):1070–4.

    Article  Google Scholar 

  21. Adams JD, Leonard RD. Fracture of the carpal scaphoid. N Engl J Med. 1928;198:401–4.

    Article  Google Scholar 

  22. Sutro CJ. Treatment of nonunion of the carpal navicular bone. Surgery. 1946;20:536–40.

    CAS  PubMed  Google Scholar 

  23. Murray G. End results of bone-grafting for non-union of the carpal navicular. J Bone JT Surg. 1946;28:749–56.

    CAS  Google Scholar 

  24. Matti H. Uber die behandling der navicularefraktur und der refractura patellae durch plombierung mit spongiosa. Zentralbl Chir. 1937;64:2353–9.

    Google Scholar 

  25. Moon ES, Dy CJ, Derman P, Vance MC, Carlson MG. Management of nonunion following surgical management of scaphoid fractures: current concepts. J Am Acad Orthop Surg. 2013;21:548–57.

    PubMed  Google Scholar 

  26. Buijze GA, Ochtman L, Ring D. Management of scaphoid nonunion. J Hand Surg. 2012;37A:1095–100.

    Article  Google Scholar 

  27. Sayegh ET, Strauch RJ. Graft choice in the management of unstable scaphoid nonunion: a systematic review. J Hand Surg. 2014;39:1500–1506e.

    Article  Google Scholar 

  28. McLaughlin HL. Fracture of the carpal navicular bone: some observations based on treatment by open reduction and internal fixation. J Bone JT Surg. 1954;36-A:765–74.

    Article  CAS  Google Scholar 

  29. Herbert TJ, Fisher WE. Management of the fractured scaphoid using a new bone screw. J Bone JT Surg Br. 1984;66B:114–23.

    Google Scholar 

  30. Lim TK, Kim HK, Koh KH, Lee HI, Woo SJ, Park MJ. Treatment of avascular proximal pole scaphoid nonunions with vascularized distal radius bone grafting. J Hand Surg. 2013;38A:1906–12e1.

    Article  Google Scholar 

  31. Panchal A, Kubiak EN, Keshner M, Fulkerson E, Paksima N. Comparison of fixation methods for scaphoid nonunions. Bull NYU Hosp Jt Dis. 2007;65:271–5.

    PubMed  Google Scholar 

  32. Jeon IH, Kochhar H, Lee BW, Kim SY, Kim PT. Percutaneous screw fixation for scaphoid nonunion in skeletal immature patients: a report of two cases. J Hand Surg. 2008;33A:656–9.

    Article  Google Scholar 

  33. Daly KD, Gill P, Magnussen PA, Simonis RB. Established nonunion of the scaphoid treated by volar wedge grafting and herbert screw fixation. J Bone JT Surg [Br]. 1996;78B:530–4.

    Google Scholar 

  34. Geissler WB, Slade JF. Fractures of the Carpal Bones. In Wolf SW, Pederson WC, Hotchkiss RN, Kozin SH, Cohen MS, eds. Green’s Operative Hand Surgery. Sixth Edition, Philadephia, PA: Churchill Livingstone; 2011:639–707.

    Google Scholar 

  35. Trumble TE. Avascular Necrosis After Scaphoid Fracture: A correlation of magnetic resonance imaging and histology. J Hand Surg Am. 1990;15:557–64.

    Article  CAS  PubMed  Google Scholar 

Suggested Readings

  • Braga-Silva. A comparison of the use of distal radius vascularized bone graft and non-vascularized iliac crest bone graft in the treatment of non-union of scaphoid fractures. J Hand Surg. 2008;33E:636–40.

    Google Scholar 

  • Goyal T, Sankineani SR, Tripathy SK. Local distal radius bone graft versus iliac crest bone graft for scaphoid nonunion: a comparative study. Musculoskelet Surg. 2013;97(2):109–14.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Thomas Jefferson University Hospital, The Franklin Suite G114, 834 Chestnut St., Philadelphia, PA, USA

    Sidney M. Jacoby

  2. Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA

    Justin D. Stull

Authors
  1. Sidney M. Jacoby
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Justin D. Stull
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sidney M. Jacoby .

Editor information

Editors and Affiliations

  1. Robert A. Chase Hand and Upper Limb Center, Stanford University Medical Center, Palo Alto, CA, USA

    Jeffrey Yao MD (Associate Professor of Orthopedic Surgery) (Associate Professor of Orthopedic Surgery)

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Jacoby, S.M., Stull, J.D. (2015). Scaphoid Nonunion: Surgical Fixation with Local Nonvascularized Bone Graft (Open). In: Yao, J. (eds) Scaphoid Fractures and Nonunions. Springer, Cham. https://doi.org/10.1007/978-3-319-18977-2_9

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-18977-2_9

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-18976-5

  • Online ISBN: 978-3-319-18977-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation