title: Correction of lunate malalignment when bone grafting scaphoid nonunion with humpback deformity: rationale and results of a technique revisited.
abstract: Patients with scaphoid nonunion with humpback deformity and collapse of the wrist were treated with palmar wedge bone grafting combined with reduction of the lunate to correct the dorsal intercalated segment instability deformity. Union was obtained at an average of 3 months, and patient satisfaction with functional outcome and pain relief was high. Palmar wedge bone grafting combined with correction of lunate malalignment successfully achieved scaphoid union, restored scaphoid length, and avoided the potential complication of scaphoid malunion. This report revisits a technique that facilitates accurate correction of lunate malalignment (dorsal intercalated segment instability) by initial reduction and pin fixation to the radius before insertion of scaphoid bone graft and internal fixation.
authors.affiliation: Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: M M
authors.initials: MM
authors.lastname: Tomaino
authors.forename: J
authors.initials: J
authors.lastname: King
authors.forename: M
authors.initials: M
authors.lastname: Pizillo
mesh_terms: D000293:Adolescent; D000328:Adult; D017760:Bone Malalignment / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D016025:Bone Transplantation / Q000379:methods; D002348:Carpal Bones / Q000293:injuries* / Q000601:surgery*; D005069:Evaluation Studies as Topic; D005500:Follow-Up Studies; D017102:Fracture Healing / Q000502:physiology; D005599:Fractures, Ununited / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006227:Hand Deformities, Acquired / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006801:Humans; D012667:Lunate Bone / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods; D011859:Radiography; D016059:Range of Motion, Articular; D016896:Treatment Outcome; D014954:Wrist Injuries / Q000000981:diagnostic imaging