Authors’ Disclosure Statement: The authors report no actual or potential conflict of interest in relation to this article.
Dr. Saper is an Orthopaedic Surgeon, Section of Orthopaedic Sports Medicine, Orthopaedic and Rehabilitation Centers, Chicago, Illinois. He was a Chief Resident at the time the article was written. Mr. Shah is a Medical Student, Boston University School of Medicine, Boston, Massachusetts. Dr. Stein is an Assistant Professor, Boston University School of Medicine; and a Hand Surgeon, Department of Orthopaedics, Boston Medical Center, Boston, Massachusetts. Dr. Jawa is an Assistant Professor, Boston University School of Medicine, Boston, Massachusetts; and a Shoulder, Hand, and Wrist Surgeon, New England Baptist Hospital, Roxbury Crossing, Massachusetts.
Address correspondence to: David Saper, MD, 1431 N Western Ave, Suite 510, Chicago IL 60622 (email, Dave.saper@gmail.com).
David Saper, MD Akash K. Shah, BA Andrew B. Stein, MD Andrew Jawa, MD . Screw Fixation Without Bone Grafting for Delayed Unions and Nonunions of Minimally Displaced Scaphoids. Am J Orthop.
August 8, 2018
TAKE-HOME POINTS
Scaphoid nonunions can occur in minimally displaced fractures.
If there is no deformity of the scaphoid delayed or nonunion, then a percutaneous screw fixation without bone grafting can reliably lead to bony union.
Not all scaphoid delayed unions and nonunions require bone grafting.
References
ABSTRACT
Delayed unions and nonunions of the scaphoid are most often treated by open reduction and internal fixation with bone grafting. We sought to evaluate a large consecutive series of nondisplaced or minimally displaced scaphoid nonunions and delayed unions treated by a compression screw without bone grafting by 2 fellowship trained hand surgeons. A total of 23 patients (19 males, 4 females) were identified who had fractures located at the distal third (2), the waist (18), and the proximal third (3). Of the 23 patients, 19 had a complete follow-up (mean follow-up period, 5.2 months) with evidence of radiographic union. There were no radiographic signs of arthrosis, osteonecrosis of the scaphoid, hardware-related complications, or reported revision surgeries. In conclusion, nonunions and delayed unions in nondisplaced or minimally displaced scaphoids without carpal malalignment can be successfully treated using compression screw fixation without bone grafting.
Continued to: Scaphoid nonunions or delayed unions with displacement...
