Purpose: To assess the healing rate of scaphoid pseudoarthrosis treated with wrist arthroscopy, olecranon bone graft, and anterograde screw fixation, as well as evaluate complications and clinical and radiologic outcomes.
Methods: All patients with scaphoid nonunion were selected between January 2017 and December 2022. Inclusion criteria were patients between 18 and 60 years of age, a diagnosis of scaphoid pseudoarthrosis, complete clinical patient-reported outcomes, radiographic measurements, and at least a 1-year follow-up. Scaphoid pseudoarthrosis was treated arthroscopically with olecranon bone graft and anterograde screw fixation. Clinical assessment was performed through visual analog scale (VAS) for pain, QuickDASH (Disabilities of the Arm, Shoulder, and Hand) questionnaire, wrist range of motion using a standard goniometer, and grip strength in kilograms with a Jamar hydraulic hand dynamometer. Clinical relevance was measured with the minimal clinically important difference (MCID) for VAS and QuickDASH. Scapholunate angle was measured. Union was assessed on a computed tomography scan.
Results: Seventeen patients were included with a mean follow-up of 17.2 months. The mean age was 30.1 years, and the average time from injury to arthroscopic surgery was 11.1 months. At latest follow-up, there was an improvement in VAS pain score and QuickDASH score. Range of motion and grip strength increased at last follow-up. MCID threshold for the VAS and QuickDASH score was reached by 100% and 94.1%, respectively. Union was achieved in 16 patients (94.1%) after a median of 16 weeks (interquartile range, 16-20).
Conclusions: Arthroscopic treatment of scaphoid pseudoarthrosis with olecranon bone graft and antegrade percutaneous headless compression screw allows a high grade of union and improves pain and function at short-term follow-up.
Level Of Evidence: Level IV, therapeutic case series.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.arthro.2024.06.020 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The elusive bipartite scaphoid: a rare congenital variant or misdiagnosed pseudoarthrosis? A proposal for novel radiological criteria.
Folia Morphol (Warsz)
January 2025
Department of Orthopedics and Traumatology, University Hospital Queen Giovanna-ISUL, Medical University of Sofia, Sofia, Bulgaria.
Variations in the development of carpal bones are uncommon, with the scaphoid bone typically forming from the fusion of the os centrale carpi and the radial chondrification center during embryogenesis. A bipartite scaphoid is a rare congenital disorder that occurs when these ossification centers fail to fuse, with a prevalence ranging from 0.1% to 0.
View Article and Find Full Text PDFArthroscopy Treatment of Scaphoid Pseudarthrosis: Description of the Technique and Case Series.
Rev Bras Ortop (Sao Paulo)
October 2024
Hospital Universitário Madrid Montepríncipe, Universidad CEU San Pablo, Boadilla del Monte, Madri, Espanha.
To describe the procedure and evaluate the results of a series of patients with stable and unstable pseudarthrosis of the scaphoids treated with the use of arthroscopy associated with cancellous bone graft and compression screw. Twenty-three patients were treated with this technique. The minimum postoperative follow-up was 12 months, and pre- and postoperative functional, clinical, and imaging analyses were performed.
View Article and Find Full Text PDFManagement of Scaphoid Pseudoarthrosis Surgery with Wide-Awake Local Anesthesia No Tourniquet (WALANT) Versus Axillary Block Anesthesia: Comparison of Patient Satisfaction.
Plast Surg (Oakv)
November 2024
Department of Orthopaedics and Traumatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
We aimed to compare clinical and functional results of treatment of scaphoid pseudoarthrosis between patients undergoing wide-awake local anesthesia no tourniquet (WALANT) versus axillary block anesthesia. The patients diagnosed with scaphoid non-union who underwent pseudoarthoris surgery were divided into WALANT group ( = 12) and axial block group ( = 11). Visual analog scores (VAS) were measured by calling the patients via phone on postoperative days 1, 2, 3, and 7.
View Article and Find Full Text PDFEffective treatment of scaphoid pseudoarthrosis is critical to reduce the risk of progression to the potentially debilitating scaphoid nonunion advanced collapse, including complications of persistent wrist joint instability, degenerative arthritis, decreased range of motion, chronic pain, and functional impairment. Both anatomic and fracture-related pathophysiology predispose patients to scaphoid nonunion, including limited retrograde blood flow, fracture location, and delay of appropriate treatment. Recent studies have demonstrated successful outcomes in treatment of scaphoid nonunions, with nonvascularized bone autograft, commonly from distal radius or iliac crest, as well as pedicled vascularized or free vascularized autograft with rates of union varying from 84% to 100%.
View Article and Find Full Text PDFHigh Rate of Union of Scaphoid Pseudoarthrosis Treated With Arthroscopic Olecranon Bone Graft Using Antegrade Percutaneous Headless Compression Screw.
Arthroscopy
December 2024
Hand Unit, Department of Orthopedic Surgery, HLA Clinica Vistahermosa, Alicante, Spain. Electronic address:
Purpose: To assess the healing rate of scaphoid pseudoarthrosis treated with wrist arthroscopy, olecranon bone graft, and anterograde screw fixation, as well as evaluate complications and clinical and radiologic outcomes.
Methods: All patients with scaphoid nonunion were selected between January 2017 and December 2022. Inclusion criteria were patients between 18 and 60 years of age, a diagnosis of scaphoid pseudoarthrosis, complete clinical patient-reported outcomes, radiographic measurements, and at least a 1-year follow-up.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!