Scaphoid non-union: factors affecting the functional outcome of open reduction and wedge grafting with Herbert screw fixation.
50 patients with scaphoid non-union were treated by open reduction, anterior wedge bone grafting and internal fixation using the Herbert screw. Intra-operative image intensifier control enabled us to insert the screw into the scaphoid accurately. An excellent or good functional outcome was less likely when more than 5 years had elapsed since injury, the non-union was in the proximal third, when sclerosis of the proximal fragment was present, and when reduction of carpal and scaphoid deformity was unsatisfactory. These four factors are believed to be the primary determinants affecting the functional results of the surgical treatment of scaphoid non-union, even when bony union is achieved.
Department of Orthopaedic Surgery, Nagoya University School of Medicine, Japan.
R
R
Nakamura
E
E
Horii
K
K
Watanabe
K
K
Tsunoda
T
T
Miura
D000293:Adolescent; D000328:Adult; D001863:Bone Screws; D002348:Carpal Bones / Q000293:injuries* / Q000601:surgery*; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods; D005599:Fractures, Ununited / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011300:Preoperative Care; D016896:Treatment Outcome