Abstract
Purpose
The purpose of the present study is to evaluate scaphoid delayed fractures or nonunions treated by percutaneous fixation with MRI correlations.
Methods
We evaluated 33 consecutive scaphoid delayed unions or nonunions treated by dorsal percutaneous fixation at a mean 16 months (range, seven to 48 months) after the operation. There were 31 male and two female patients with an average age of 29 years (range, 25–33 years).
Results
Pre-operative MRI revealed no signs of avascular necrosis. At the latest follow-up, all patients had good or excellent results.
Conclusion
We suggest dorsal percutaneous screw fixation for scaphoid delayed fractures or nonunions after eliminating the presence of AVN by pre-operative MRI examination.
Similar content being viewed by others
References
Gunal I, Calli I, Barton N (2002) Current management of scaphoid fractures. Twenty questions answered. Royal Society of Medicine Press, London
Capo JT, Shamian B, Rizzo M (2012) Percutaneous screw fixation without bone grafting of scaphoid non-union. Isr Med Assoc J 14:729–732
Naranje S, Kotwal PP, Shamshery P, Gupta V, Nag HL (2010) Percutaneous fixation of selected scaphoid fractures by dorsal approach. Int Orthop 34:997–1003
Saint-Cyr M, Oni G, Wong C, Sen MK, LaJoie AS, Gupta A (2011) Dorsal percutaneous cannulated screw fixation for delayed union and nonunion of the scaphoid. Plast Reconstr Surg 128:467–473
Slade JF III, Geissler WB, Gutow AP, Merrell GA (2003) Percutaneous internal fixation of selected scaphoid nonunions with an arthroscopically assisted dorsal approach. J Bone Joint Surg 85-A:20–32
Wozasek GE, Moser KD (1991) Percutaneous screw fixation for fractures of the scaphoid. J Bone Joint Surg 73-B:138–142
Gunal I, Altay T (2011) Avascular necrosis of the scaphoid in children treated by splint immobilization: a report of two cases. J Bone Joint Surg 93-B:847–848
Gunal I, Ozcelik A, Gokturk E, Ada S, Demirtas M (1999) Correlation of magnetic resonance imaging and intraoperative punctate bleeding to assess the vascularity of scaphoid nonunion. Arch Orthop Trauma Surg 119:285–287
Cooney WP, Bussey R, Dobyns JH, Linscheid RL (1987) Difficult wrist fractures: perilunate fracture-dislocations of the wrist. Clin Orthop 214:136–147
Jeon IH, Micic ID, Oh CW, Park BC, Kim PT (2009) Percutaneous screw fixation for scaphoid fracture: a comparison between the dorsal and the volar approaches. J Hand Surg 34-A:228–236
Ozcelik A, Gunal I, Kose N, Seber S (2005) Wrist ligaments: their significance in carpal instability. Ulus Travma Derg 11:115–120
Seber S, Gokdemir H, Ozcelik A, Gunal I, Aydın R, Kose N (2008) A two-dimensional wrist model for carpal instability and force transmission. Eklem Hastalik Cerrahisi 19:127–132
Gunal I, Kose N, Erdogan O, Gokturk E, Seber S (1996) Normal range of joint movements in upper extremity joints in male subjects with special reference to side. J Bone Joint Surg 78 - A:1401–1404
Buijze GA, Ochtman L, Ring D (2012) Management of scaphoid nonunion. J Hand Surg 37- A:1095–1100
Bilic R, Simic P, Jelic M, Stern-Padovan R, Dodig D, Pompe van Meerdervoort R, Martinovic S, Ivankovic D, Pecina M, Vukicevic S (2006) Osteogenic protein-1 (BMP-7) accelerates healing of scaphoid non-union with proximal pole sclerosis. Int Orthop 30:128–134
Ricardo M (2006) The effect of ultrasound on the healing of muscle-pediculated bone graft in scaphoid non-union. Int Orthop 30:123–127
Conflict of interest
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Altay, T., Gunal, I., Kayali, C. et al. Dorsal percutaneous screw fixation of delayed or nonunion of scaphoid fractures. International Orthopaedics (SICOT) 38, 1007–1010 (2014). https://doi.org/10.1007/s00264-014-2282-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00264-014-2282-5