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Long-term clinical and radiological results after scaphoid non-union treatment: a retrospective study about 60 cases

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Abstract

Purpose

Scaphoid non-union treatment remains nonconsensual and is based on vascularized or non-vascularized bone grafting. This study aimed to evaluate with a long follow-up the functional, clinical, and radiological outcomes, reported complications and reoperations and studied non-union treatment prognostic factors.

Methods

Patients who had undergone bone graft surgery for scaphoid non-union were retrospectively reviewed. The evaluated outcomes were pain, qDASH, PRWE and MWS scores, active range of motion, grip strength, union rate, scapholunate angle, carpal height, and presence of arthrosis. Complications and reinterventions were also reported.

Results

This study included 60 scaphoid non-union treatments with a mean follow-up of 7.7 (1.5–20.3) years. Twenty (33.3%) non-unions were located at the proximal pole, including 6 (10%) with preoperative avascular necrosis (AVN). Union occurred in 51 patients (85%). The functional, clinical, and radiological results were good. The complication rate was 21.3% and the reintervention rate was 16.7%. Subgroup union rate analysis found no difference if the non-union is localized in the proximal pole or if there is AVN.

Conclusion

With a representative sample of the population and a long follow-up, we have found a good union rate, clinical and functional results regardless of the treatment method chosen. Scaphoid non-union treatment is still controversial and more studies are needed to accurate indications of each graft according to the patient and non-union characteristics.

Level of Evidence IV

Retrospective cohort study.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Service d’Orthopédie 1, Hôpital Roger Salengro, rue Émile Laine, 59000, Lille, France

    Morgane Delamarre, Maxime Barbarin, Christophe Chantelot & Marc Saab

  2. Statistics, Economic Evaluation, Data-Management (SEED), CHU Lille, 59037, Lille Cedex, France

    Maxime Leroy

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  1. Morgane Delamarre
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Contributions

All authors of this submission made substantial contributions to the conception or design of the work (MD, MS); or the acquisition, analysis, or interpretation of data (MD, MB, ML); drafted the work (MD, ML, MS) or revised it critically (CC) for important intellectual content; approved the version to be published; and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Correspondence to Marc Saab.

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Conflict of interest

M.D. has no conflicts of interest; M.L. has no conflicts of interest; M.B. has no conflict of interest; C.C. has no conflict of interest; M.S. has occasional consultant for COUSIN SURGERY® and QUANTA MEDICAL®.

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Delamarre, M., Leroy, M., Barbarin, M. et al. Long-term clinical and radiological results after scaphoid non-union treatment: a retrospective study about 60 cases. Eur J Orthop Surg Traumatol 34, 507–515 (2024). https://doi.org/10.1007/s00590-023-03687-8

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