title: [Long-term results of surgical treatment of scaphoid non union: influence of the correction of dorsal intercalated segment instability].
abstract: OBJECTIVE
  The publications dealing with scaphoid non-union emphasize importance of correction of the Dorsal Intercalated Segment Instability (DISI) to achieve good functional results and to prevent osteoarthritis. The purpose of this study was to assess, over 10 years follow-up, the functional outcomes of 25 patients with scaphoid non-union surgery. X-ray and DISI deformity were assessed.
  
  
  METHODS
  Between 1994 and 1998, 53 patients underwent surgery for scaphoid non-union. Over 10 years follow-up, functional evaluation based on pain, QuickDASH and Mayo Wrist Score was performed, and a physical examination including mobility, strength and pain on the region of the scaphoid. Outcomes on X-rays were assessed by searching osteoarthritis damages and by measuring carpal height index and intracarpal angles.
  
  
  RESULTS
  Eight patients had pain on the scaphotrapeziotrapezoidal joint without degenerative lesions on radiography. Compared to other patients, they had worse functional results, decrease of scapholunate angle, decrease of the DISI and increase of carpal height.
  
  
  CONCLUSIONS
  The correction of the DISI is not always associated with good functional results. Although there were no osteoarthritic changes on the radiography, residual pain may be related to affection of the scapho-trapezo-trapezoidal joint. Surgical treatment with osteotomy of the scaphoid seems to be dangerous because of the moderate impact on function for these patients.
authors.affiliation: Département de chirurgie de la main et du membre supérieur, CHU Lapeyronie, Montpellier cedex, France. hubert.lenoir@laposte.net
authors.forename: H
authors.initials: H
authors.lastname: Lenoir
authors.forename: C
authors.initials: C
authors.lastname: Lazerges
authors.forename: B
authors.initials: B
authors.lastname: Coulet
authors.forename: O
authors.initials: O
authors.lastname: Mares
authors.forename: M
authors.initials: M
authors.lastname: Chammas
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005599:Fractures, Ununited / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods; D012189:Retrospective Studies; D021361:Scaphoid Bone / Q000293:injuries* / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult