title: Functional results and quality of life after bilateral scaphoid reconstruction: a case series.
abstract: Unilateral scaphoid non-union remains a major problem, which can lead to major functional limitations. Until now there is no evidence of outcome of the rare case of bilateral scaphoid non-unions and in how far two-stage bilateral reconstruction affects functional results and the quality of life. Between 1997 and 2010, altogether four bilateral scaphoid non-unions were treated in the centre and retrospectively analyzed. The mean follow-up was performed 36.8 months after reconstruction. The measures included analysis of patient data, analysis of functional measures and quality of life after follow-up. The reconstructions were performed with implantation of a free, non-vascularized iliac crest bone graft (4), osteosynthesis with implantation of a pedicled vascularized bone graft (3) and osteosynthesis with cancellous bone graft (1). The mean range of motion of the wrist was extension/flexion 111.3°. The average grip strength by JAMAR dynamometer showed right versus left sight 32.7 kg (±3.5) versus 33.7 (±2.9). The evaluation of the DASH score resulted in 11.6 (±12.5), the SF36 scale in 87.1 (±9.2) points. The present case series for the first time demonstrated functional mid-term results of the rare event of bilateral scaphoid reconstruction after non-union. With respect to the impact on one affected hand, functional results, DASH score and quality of life are excellent and thus justify good prognosis in patient education after injury.
authors.affiliation: Department of Hand, Plastic and Reconstructive Surgery, Burn Centre, BG Trauma Centre, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen/Rhine, Germany.
authors.forename: Marcus
authors.initials: M
authors.lastname: Corsten
authors.forename: Christian
authors.initials: C
authors.lastname: Heffinger
authors.forename: Leila
authors.initials: L
authors.lastname: Kolios
authors.forename: Marcus
authors.initials: M
authors.lastname: Lehnhardt
authors.forename: Berthold
authors.initials: B
authors.lastname: Bickert
authors.forename: Christoph
authors.initials: C
authors.lastname: Hirche
mesh_terms: D000328:Adult; D016025:Bone Transplantation; D005599:Fractures, Ununited / Q000601:surgery*; D018737:Hand Strength; D006801:Humans; D007085:Ilium / Q000637:transplantation*; D008297:Male; D011788:Quality of Life; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures; D020127:Recovery of Function; D012189:Retrospective Studies; D021361:Scaphoid Bone / Q000293:injuries* / Q000601:surgery*; D014954:Wrist Injuries / Q000601:surgery*; D014955:Wrist Joint / Q000601:surgery*; D055815:Young Adult