title: The treatment of scaphoid nonunion using the Ilizarov fixator without bone graft, a study of 18 cases.
abstract: OBJECTIVE
  Evaluating the safety and efficacy of the Ilizarov fine-wire compression/distraction technique in the treatment of scaphoid nonunion (SNU), without the use of bone graft.
  
  
  METHODS
  A retrospective review of 18 consecutive patients in one centre.
  
  
  METHODS
  18 patients; 17 males; 1 female, with a mean SNU duration of 13.9 months. Patients with carpal instability, humpback deformity, carpal collapse, avascular necrosis or marked degenerative change, were excluded. Following frame application the treatment consisted of three stages: the frame was distracted 1 mm per day until radiographs showed a 2-3 mm opening at the SNU site (mean 10 days); the SNU site was then compressed for 5 days, at a rate of 1 mm per day, with the wrist in 15 degrees of flexion and 15 degrees of radial deviation; the third stage involved immobilization with the Ilizarov fixator for 6 weeks. The technique is detailed herein.
  
  
  RESULTS
  Radiographic (CT) and clinical bony union was achieved in all 18 patients after a mean of 89 days (70-130 days). Mean modified Mayo wrist scores improved from 21 to 86 at a mean follow-up of 37 months (24-72 months), with good/excellent results in 14 patients. All patients returned to their pre-injury occupations and levels of activity at a mean of 117 days. Three patients suffered superficial K-wire infections, which resolved with oral antibiotics.
  
  
  CONCLUSIONS
  In these selected patients this technique safely achieved bony union without the need to open the SNU site and without the use of bone graft.
authors: Institute for Orthopaedic Surgery and Traumatology, Clinical Center of Serbia, Belgrade, Serbia.
authors: Marko
authors: M
authors: Bumbaširević
authors: Slavko
authors: S
authors: Tomić
authors: Aleksandar
authors: A
authors: Lešić
authors: Vesna
authors: V
authors: Bumbaširević
authors: Zoran
authors: Z
authors: Rakočević
authors: Henry D
authors: HD
authors: Atkinson
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005599:Fractures, Ununited / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D018889:Ilizarov Technique / Q000295:instrumentation*; D008297:Male; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D021361:Scaphoid Bone / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult