title: [Treatment algorithm for scaphoid nonunion : retrospective case-control study of 208 patients].
abstract: BACKGROUND
  We present a retrospective study on different treatment options for scaphoid nonunion. The results are compared to the literature and a treatment algorithm is proposed.
  
  
  METHODS
  Based on a retrospective case-control study, 208 patients suffering from scaphoid nonunion were treated between 2000 and 2006. The patients were grouped depending on the localization of the nonunion: proximal (n=10), middle (n=105), or distal (n=93) third. In the presence of a small avascular proximal fragment, a vascularized bone graft from the distal radius was added (n=53). The determination of scaphoid healing was achieved by conventional radiographs or CT scans.
  
  
  RESULTS
  Overall scaphoid healing occurred in 89.9% (n=187). For small proximal scaphoid fragments (n=93), we could show healing rates up to 83% (n=77). Using a vascularized bone graft from the distal radius, scaphoid consolidation was achieved in 81% for avascular proximal fragments and recurrent scaphoid nonunion (n=53).
  
  
  CONCLUSIONS
  Using sophisticated treatment options, the prognosis of scaphoid nonunions is very good.
authors.affiliation: Klinik für Hand-, Plastische, Rekonstruktive und Verbrennungschirurgie, Berufsgenossenschaftliche Unfallklinik, Eberhard-Karl-Universität Tübingen, Schnarrenbergstraße 95, 72076, Tübingen, Deutschland. patrickjaminet@googlemail.com
authors.forename: P
authors.initials: P
authors.lastname: Jaminet
authors.forename: F
authors.initials: F
authors.lastname: Werdin
authors.forename: M
authors.initials: M
authors.lastname: Pfau
authors.forename: M
authors.initials: M
authors.lastname: Götz
authors.forename: T
authors.initials: T
authors.lastname: Manoli
authors.forename: A
authors.initials: A
authors.lastname: Rahmanian-Schwarz
authors.forename: H E
authors.initials: HE
authors.lastname: Schaller
mesh_terms: D000328:Adult; D000465:Algorithms; D016025:Bone Transplantation / Q000706:statistics & numerical data*; D002348:Carpal Bones / Q000601:surgery*; D016022:Case-Control Studies; D005260:Female; D017759:Fractures, Malunited / Q000453:epidemiology* / Q000601:surgery*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D015995:Prevalence; D016896:Treatment Outcome