Scaphoid Nonunions

Scaphoid nonunions are challenging injuries to manage and the optimal treatment algorithm continues to be debated. Most scaphoid fractures heal when appropriately treated; however, when nonunions occur, they require acute treatment to prevent future complications like scaphoid nonunion advanced coll...

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Bibliographic Details
Published in:Bulletin of the Hospital for Joint Diseases (2013) 2018-03, Vol.76 (1), p.27-32
Main Authors: Klifto, Christopher S, Ramme, Austin J, Sapienza, Anthony, Paksima, Nader
Format: Article
Language:English
Subjects:
Bone Transplantation - adverse effects
Fracture Healing
Fractures, Ununited - diagnostic imaging
Fractures, Ununited - physiopathology
Fractures, Ununited - surgery
Hand Injuries - diagnostic imaging
Hand Injuries - physiopathology
Hand Injuries - surgery
Humans
Scaphoid Bone - diagnostic imaging
Scaphoid Bone - injuries
Scaphoid Bone - physiopathology
Scaphoid Bone - surgery
Treatment Outcome
Vascular Grafting - adverse effects
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Summary:Scaphoid nonunions are challenging injuries to manage and the optimal treatment algorithm continues to be debated. Most scaphoid fractures heal when appropriately treated; however, when nonunions occur, they require acute treatment to prevent future complications like scaphoid nonunion advanced collapse. Acute nonunion treatment technique depends on nonunion location, vascular status of the proximal pole, fracture malalignment, and pre-existing evidence of arthrosis. Bone grafting and vascular grafts are common in nonunion management. Chronic nonunions that have progressed to scaphoid nonunion advanced collapse often require a salvage procedure such as four corner fusions, proximal row carpectomy, or wrist fusion. Herein, we review the current literature regarding scaphoid nonunions with regards to their anatomy, natural history, classification, diagnostic imaging, surgical management, and clinical outcomes.
ISSN:2328-5273