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Treatment of Scaphoid Nonunion: Radiologic Outcome of 286 Patients in 10 Years
We analyzed the radiologic outcome of different treatment options for scaphoid nonunion. The results were compared with literature, and a treatment algorithm was proposed. On the basis of a retrospective case-control study, 286 patients suffering from scaphoid nonunion were treated over a 10-year pe...
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Published in: | Eplasty 2019, Vol.19, p.e5-e5 |
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Main Authors: | , , , , |
Format: | Article |
Language: | English |
Online Access: | Get full text |
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Summary: | We analyzed the radiologic outcome of different treatment options for scaphoid nonunion. The results were compared with literature, and a treatment algorithm was proposed.
On the basis of a retrospective case-control study, 286 patients suffering from scaphoid nonunion were treated over a 10-year period. Patients were grouped depending on the location of the nonunion: proximal (
= 126), middle (
= 130), or distal (
= 30) third. In the presence of an avascular proximal fragment or after prior unsuccessful operation, interposition of a vascularized pedicled bone graft from the distal radius was performed (
= 82). Scaphoid healing was detected by conventional radiography and computed tomography.
Excellent healing rates of 96.3% were obtained for middle and distal third scaphoid nonunions by conventional iliac crest bone grafting (
= 137). Furthermore, we achieved healing rates of 91.3% for persistent nonunions using a palmar vascularized bone graft from the distal radius after prior unsuccessful operation (
= 23). When using a dorsal vascularized bone graft from the distal radius, scaphoid consolidation was reached in 81.1% for avascular proximal fragments (
= 59).
Applying a sophisticated treatment algorithm, the prognosis of scaphoid nonunion is very good. |
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ISSN: | 1937-5719 1937-5719 |