[Proximal scaphoid pseudarthrosis--reconstruction by dorsal bone screw and spongiosa transplantation].
Stable fixation of small proximal pole nonunions of the scaphoid by conventional techniques of bone grafting remains difficult. Because of this, long-lasting immobilisation is necessary. Treatment by retrograde Herbert-screw fixation offers the possibility of stable osteosynthesis resulting in shorter immobilisation. Even in case of avascular proximal fragments, it allows healing of the nonunion. We report on the 29 months follow-up of 23 patients treated in this manner showing bony consolidation in 17 cases (74%). Four patients demonstrated fibrous nonunion with minor symptoms, and in two patients persistent nonunion with slight impairment was seen. Evaluation with the DASH-questionnaire revealed slight disability with an average score of ten points. The availability of the mini-Herbert-screw has improved this treatment concept.
Klinik für Handchirurgie, Abteilung I, Rhön-Klinikum, Bad Neustadt/Saale.
H
H
Krimmer
E
E
Kremling
J
J
van Schoonhoven
K J
KJ
Prommersberger
P
P
Hahn
D000328:Adult; D001863:Bone Screws; D016025:Bone Transplantation / Q000295:instrumentation*; D002348:Carpal Bones / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011542:Pseudarthrosis / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D016896:Treatment Outcome
Proximale Kahnbeinpseudarthrose--Rekonstruktion durch dorsale Verschraubung und Spongiosa-Transplantation.