Repeat Russe bone grafting after failed bone graft surgery for scaphoid non-union.
We report the long-term outcome of repeat Russe bone grafting after failure of a previous Russe graft for scaphoid non-union. 15 patients were followed for a mean of 71 months after their last surgical procedure. 11 patients had undergone a single previous Russe graft and four patients had two previous graft attempts. Internal fixation was used in only three patients. Eight out of 15 (53%) patients achieved union after a single repeat graft and one out of four united after a third attempt. When union was achieved, range of motion was unchanged, grip strength was increased 10% and pain was slight to none, allowing return to full employment in seven out of the nine patients. All patients who did not achieve union have either undergone a salvage procedure or are contemplating one. Based on the literature and our relatively low rate of union without internal fixation (53%), we recommmend supplementary internal fixation if repeat Russe bone grafting is undertaken. When union is achieved, satisfactory results can be expected.
Bynum
E B
EB
Department of Orthopaedic Surgery, Naval Medical Centre, Oakland, California, USA.
Culp
R W
RW
Bonatus
T J
TJ
Alexander
C E
CE
McCarroll
H R
HR
D000293:Adolescent; D000328:Adult; D016025:Bone Transplantation / Q000379:methods*; D002348:Carpal Bones / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005599:Fractures, Ununited / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D012086:Reoperation; D017211:Treatment Failure