Arthroscopic treatment of Scaphoid nonunion: technique outcomes
| Date |
|---|
2022-09-07 |
no. 6.7.
Oral Presentation Abstracts. 6. Shoulder, Elbow and Wrist Symposium
ISBN 978-609-96167-6-6
Introduction Scaphoid is the most commonly fractured wrist bone. Occurring mainly in young males, counting up to 30/100'000 of the whole population. Althougheven after timely and appropriate scaphoid fracture treatment nonunion events up to 12 % of cases. In this scenario a surgical approach is indicated, though with even worse outcomes. Depending on literature sources at least one fifth of scaphoid nonunions treated surgically fails and wrist degeneration progresses. There is a great need for advanced, alternative surgical techniques in treating scaphoid nonunions. One of the latest options is arthroscopic treatment of scaphoid nonunion with bone graft. Outcomes of arthroscopic nonunion treatment in Hospital of Lithuanian University of Health Sciences (LSMU), Kaunas Clinics will be presented. Aims and Objectives The aim of the study is to evaluate the outcome of minimally invasive tretment technique of scaphoid nonunion depending on union rates, wrist pain and epidemiologic factors. Materials and methods A group was formed of 9 patients that undergone surgery due to scaphoid nonunion. Initial treatment of the fracture, time after the first trauma, fracture morphology, age, gender and tobacco usage was documentated. Standard wrist arthroscopy was performed, following debridement of the nonunion area and radius auto bone grafting. Up to half of the cases fibrin glue were applied on the graft, hereby two smaller study groups for expedience of fibrin glue usage were formed. Bone was fixed with two Kirschner wires and immobilised. After 3 months Kirshner wires were removed and radiographic evaluation using x-ray and CT scan performed. Bone union was evaluated by a radiologist on x-rays and CT scans. Additionally wrist pain evaluation was done 6–12 months after surgery. Results Study group consisted of 7/9 males and 2/9 ladies ranging from 19 to 39 years of age. Scaphoid proximal part fractures consisted 5/9 cases, while 4/9 were waist fractures. Less than half, 4/9, patients reported tobacco usage, which could impair bone healing. A […].