Reconstruction of scaphoid waist non-unions using a radial approach: Preliminary outcome analyses Reconstruction des pseudarthroses du tiers moyen du scaphoïde par voie radiale: analyse des résultats préliminaires


Arik A., ÖZCANYÜZ B., Cevik K.

Hand Surgery and Rehabilitation, cilt.41, sa.3, ss.334-340, 2022 (Scopus) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 41 Sayı: 3
  • Basım Tarihi: 2022
  • Doi Numarası: 10.1016/j.hansur.2022.02.008
  • Dergi Adı: Hand Surgery and Rehabilitation
  • Derginin Tarandığı İndeksler: Scopus
  • Sayfa Sayıları: ss.334-340
  • Anahtar Kelimeler: Bone graft, Radial approach, Scaphoid non-union, Styloidectomy, Surgical treatment
  • Akdeniz Üniversitesi Adresli: Evet

Özet

© 2022 SFCMThis study aimed to evaluate clinical and radiographic outcomes in a consecutive series of patients who underwent open surgery via a radial approach for reconstruction of scaphoid waist non-union. Over a 2-year period, 16 males with scaphoid waist non-union received surgery using a radial approach; we performed limited styloidectomy, biconcave curettage, ovoid bone grafting from the styloidectomy fragment, and placement of a retrograde radial-entry screw. Mean patient age was 25.1 years (range 17–56 years). Bony union was determined on radiographs and computed tomography. Radiographic variables were measured on preoperative and final follow-up radiographs. Mean follow-up was 14 months (range 8–19 months). Subjective and objective outcomes were recorded. Radiographic healing was achieved in 14 of the 16 patients (88%) at a mean 4½ months after surgery (range 3–6 months). Significant postoperative improvements were found in mean carpal height ratio (from 0.48 to 0.53) and radiolunate angle (from 8.2° to 2.8°) compared to preoperative data. Mean postoperative wrist extension was 54° (range 32–67°) and mean flexion 49° (range 2–64°). Mean flexion arc after surgery was 84.1% that of the contralateral side. Mean grip strength was 85.2% that of the contralateral side. Subjective results comprised mean postoperative Modified Mayo Wrist score of 82.3 (range 55–90) and Quick Disabilities of the Arm, Shoulder and Hand score of 11.2 (range 0–36.4). Twelve of the 14 healed wrists were subjectively rated as good or excellent. Repair of scaphoid non-union via a radial approach was safe and effective. Union rates were high and outcomes were good.