Arthroscopic realignment and osteosynthesis of unstable scaphoid nonunion with cancellous bone graft from the ipsilateral radius

Hsiung, Wei; Huang, Haichao; Wang, Jung Pan; Chang, Ming Chau; Huang, Yi

doi:10.1007/s00264-020-04840-2

Cited by 20 publications

(17 citation statements)

References 29 publications

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“…The comparative study showed that the open approach group had better radiographic alignment correction than the arthroscopic approach group, but with similar union rates and functional results [27]. However, Hsiung et al have demonstrated that arthroscopic realignment and osteosynthesis of unstable scaphoid nonunion achieved good clinical and radiographic results [31]. The connection between alignment and clinical results remains unclear; however, Kim et al have demonstrated that arthroscopic reduction and osteosynthesis of chronic unstable scaphoid nonunion were limited for restoring normal carpal alignment but had positive effects on the recovery of wrist function [32].…”

Section: Resultsmentioning

confidence: 99%

Arthroscopic treatment of stable nonunion, unstable nonunion, or nonunion of the scaphoid with early degenerative radioscaphoid arthritis

Shih

2022

Preprint

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Background: This study was designed to analyze the clinical follow-up results (minimum of 2 years) in patients with stable nonunion, unstable nonunion, or nonunion of the scaphoid with early degenerative radioscaphoid arthritis (Lichtman classification stage I–III) treated with arthroscopic osteosynthesis with autogenous bone graft.Methods: We retrospectively recruited 44 consecutive patients with scaphoid fracture nonunion treated with arthroscopy-assisted percutaneous internal fixation with autogenous bone grafts from January 2010 to November 2019. We recorded union and return to activity and analyzed data with regular clinical follow-up at a mean duration of 33 months (range, 24–46 months). Clinical (i.e., visual analog scale pain score, grip strength, and range of motion), radiographic, and functional (Mayo Modified Wrist Score (MMWS)) outcomes at the final follow-up were compared with the preoperative assessments and analyzed in patients with different stages. Results: We confirmed union in 39 of the 44 patients (88.6%) after a mean 15.4 weeks post-operatively according to clinical examinations and standard radiography. All clinical parameters improved significantly. For the MMWS, there were 25 excellent and 14 good results. Of the 44 patients, 40 (90.9%) returned to work or sports activities at their preinjury levels. Comparisons of the outcomes between patients in different stages of scaphoid nonunion revealed no significant difference in the aspect of union rate, VAS pain score, and functional score improvement.Conclusions: Arthroscopic osteosynthesis with autogenous bone grafts is a reliable and minimally invasive method for achieving nonunion healing and improving clinical outcomes in stage I–III scaphoid nonunion.Level of Evidence: Level IV, case series.

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Section: Resultsmentioning

confidence: 99%

Arthroscopic treatment of stable nonunion, unstable nonunion, or nonunion of the scaphoid with early degenerative radioscaphoid arthritis

Shih

2022

Preprint

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“…Union incidence dropped from 93% in the bleeding group to 79% in the non-bleeding group. Other authors have described similar techniques with union incidence in the range of 93%–100% and union time from 9.7 weeks to 4 months (Cognet et al., 2017; Hsiung et al., 2021; Kang et al., 2016; Lee et al., 2018; Liu et al., 2019). Oh et al.…”

Section: Arthroscopic Bone Grafting In Scaphoid Nonunion (By Pak Cheong Ho)mentioning

confidence: 95%

Revolutions in arthroscopic wrist surgeries

Nakamura

Atzei³

et al. 2021

J Hand Surg Eur Vol

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Recent technical and technological developments in wrist arthroscopic surgery allow for advanced treatments of difficult wrist disorders. In this review, world leaders of wrist arthroscopy describe bone graft for scaphoid nonunion, transosseous repair for triangular fibrocartilage fovea avulsion, palmaris longus reconstruction of the triangular fibrocartilage, and arthroscopic reconstruction of the scapholunate and lunotriquetral ligaments.

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“…Arthroscopy-assisted scaphoid fixation has been described in several studies as a suitable technique to achieve anatomic reduction and improved outcomes. [ 1 - 4 ] This technique is also useful in the identification and intervention of concomitant intra-articular injuries. [ 2 , 3 ] Furthermore, a larger and detailed visualization of the fracture line by arthroscopy is useful for correct positioning of the guidewire and for assessing the absence of screw protrusion in the joint.…”

Section: Introductionmentioning

confidence: 99%

“…The most important benefit of arthroscopic fracture fixation over open methods is the direct visualization of the intra-articular space and fracture, thus allowing anatomical fixation and repair of the soft tissues to be performed simultaneously.Arthroscopy-assisted scaphoid fixation has been described in several studies as a suitable technique to achieve anatomic reduction and improved outcomes. [1][2][3][4] This technique is also useful in the identification and intervention of concomitant intra-articular injuries. [2,3] Furthermore, a largerObjectives: This study aims to evaluate the role of arthroscopy in the diagnosis of concomitant injuries, to investigate the relationship between comminution and concomitant injuries, and to analyze the effect of concomitant injuries on functional outcomes in acute and subacute scaphoid fracture.…”

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confidence: 99%

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The role of arthroscopy in the diagnosis of concomitant soft tissue injuries in scaphoid fractures and the effect of concomitant soft tissue injuries and fracture comminution on outcomes: A case-control study

et al. 2021

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Objectives This study aims to evaluate the role of arthroscopy in the diagnosis of concomitant injuries, to investigate the relationship between comminution and concomitant injuries, and to analyze the effect of concomitant injuries on functional outcomes in acute and subacute scaphoid fracture. Patients and methods Between January 2011 and September 2018. A total of 32 acute scaphoid fracture patients (29 males, 3 females; mean age: 30±12 years; range, 18 to 65 years) were retrospectively analyzed. None of them had an obvious ligament injury in the radiological assessment. Functional outcomes were compared between concomitant and non-concomitant injuries and between comminuted and non-comminuted injuries. The percentage of range of motion (ROM), grip, and pinch strength were recorded according to the contralateral extremity to detect the restriction rate. The Mayo Wrist Score (MWS), the Turkish version of the Quick Disability of the Arm, Shoulder, and Hand (Q-DASH) and Patient-Rated Wrist Evaluation (PRWE) questionnaires were used to evaluate the functional results. Subjective pain was assessed using the Visual Analog Scale (VAS). The relationship between concomitant injuries and comminution was investigated. Results There were 13 patients with comminuted fractures. Concomitant injuries were diagnosed in 17 patients. The presence of concomitant injuries was higher in comminuted fractures than in non-comminuted fractures. There was no significant difference between the groups in ROMs. The final follow-up Q-DASH, PRWE, MWS, and VAS scores and the pinch strength of non-comminuted fractures were found to be statistically better than those of comminuted fractures. There were statistically worse Q-DASH, PRWE, MWS, and VAS scores in patients with concomitant injuries. Conclusion Arthroscopic scaphoid fracture surgery allows the diagnosis and treatment of concomitant lesions. The functional outcomes of concomitant lesions and comminuted fractures seem to be worse than those of others, while the ROM is comparable.

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Arthroscopic realignment and osteosynthesis of unstable scaphoid nonunion with cancellous bone graft from the ipsilateral radius

Cited by 20 publications

References 29 publications

Arthroscopic treatment of stable nonunion, unstable nonunion, or nonunion of the scaphoid with early degenerative radioscaphoid arthritis

Arthroscopic treatment of stable nonunion, unstable nonunion, or nonunion of the scaphoid with early degenerative radioscaphoid arthritis

Revolutions in arthroscopic wrist surgeries

The role of arthroscopy in the diagnosis of concomitant soft tissue injuries in scaphoid fractures and the effect of concomitant soft tissue injuries and fracture comminution on outcomes: A case-control study

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