Abstract
The aim of the study was to evaluate results of volar percutaneous headless compression screw fixation without bone grafting in 21 patients with scaphoid waist nonunion fractures. The inclusion criteria in this series were scaphoid waist fracture nonunion with intact cartilaginous envelope, minimal fracture line at nonunion interface, no cyst or sclerosis, no avascular necrosis and normal scapholunate angle without humpback deformity. There were 17 male and 4 female patients with an average age of 23 years (range 16–45 years). All patients had radiographic examinations that included Posteroanterior, lateral, oblique and scaphoid views. Preoperative MRI to assess the cartilaginous shill and vascularity of scaphoid was done. CT scans were performed postoperatively to confirm scaphoid fracture healing. The average clinical follow-up was at 25 months (range 18–35) postoperatively. All fractures united successfully with no additional procedures. The average DASH score (disabilities of the arm, shoulder, and hand) at final follow-up was 8 (range 0–16). Percutaneous fixation for selected scaphoid nonunion can avoid the morbidity of an open approach and bone grafting.
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References
Bond CD, Shin AY, McBride MT, Dao KD (2001) Percutaneous screw fixation or cast immobilization for nondisplaced scaphoid fractures. J Bone Joint Surg Am 83:483–488
Capo JT, Shamian B, Rizzo M (2012) Percutaneous screw fixation without bone grafting of scaphoid nonunion. IMAJ 14:729–732
Kim JK, Kim JO, Lee SY (2010) Volar percutaneous screw fixation for scaphoid waist delayed union. Clin Orthop Relat Res 468:1066–1071
Kozin SH (2001) Incidence, mechanism, and natural history of scaphoid fractures. Hand Clin 17:515–524
Ledoux P, Chahidi N, Moermans JP, Kinnen L (1995) Percutaneous Herbert screw osteosynthesis of the scaphoid bone. Acta Orthop Belg 61:43–47
McQueen MM, Gelbke MK, Wakefield A, Will EM, Gaebler C (2008) Percutaneous screw fixation versus conservative treatment for fractures of the waist of the scaphoid: a prospective randomised study. J Bone Joint Surg (Br) 90:66–71
Merrell GA, Wolfe SW, Slade JF III (2002) Treatment of scaphoid nonunions: quantitative meta-analysis of the literature. J Hand Surg [Am] 27:685–691
Osterman AL, Mikulics M (1988) Scaphoid nonunion. Hand Clin 14:437–455
Simonian PT, Trumble TE (1994) Scaphoid nonunion. J Am Acad Orthop Surg 2:185–191
Slade JF III, Dodds SD (2006) Minimally invasive management of scaphoid nonunions. Clin Orthop Relat Res 445:108–119
Slade JF 3rd, Geissler WB, Gutow AP, Merrell GA (2003) Percutaneous internal fixation of selected scaphoid nonunions with an arthroscopically assisted dorsal approach. J Bone Joint Surg Am 85-A(Suppl 4):20–32
Streli R (1970) Percutaneous screwing of the navicular bone of the hand with a compression drill screw (a new method). Zentralbl Chir 95:1060–1078
Wozasek GE, Moser KD (1991) Percutaneous screw fixation for fractures of the scaphoid. J Bone Joint Surg (Br) 73:138–142
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The author declares that he has no conflict of interest.
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All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/ or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standers.
Informed Consent
Informed consent was obtained from all individual participants included in this study.
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Hegazy, G. Percutaneous Screw Fixation of Scaphoid Waist Fracture Non-Union Without Bone Grafting. J Hand Microsurg 7, 250–255 (2015). https://doi.org/10.1007/s12593-015-0194-2
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DOI: https://doi.org/10.1007/s12593-015-0194-2