title: [Is non-vascularized autografting in the proximal scaphoid nonunions ineffective?].
abstract: OBJECTIVE
  In this study, we aimed to evaluate the results of proximal scaphoid non-union treated with non-vascularized bone grafting and screw fixation.
  
  
  METHODS
  Thirteen patients who were treated surgically for proximal scaphoid non-union with a minimum of one-year follow-up in our clinic were evaluated. Wrist movements were measured by standard goniometry and muscle strength by hand dynamometry. Non-union was classified radiologically according to the Schernberg classification, while functional assessment was performed based on the Herbert-Fisher Grading System and the Mayo Clinic Modified Wrist Scoring System.
  
  
  RESULTS
  The mean follow-up period was 14 months (range, 12 to 40 months). Full union was observed in eight of 13 patients (61.5%). The mean time to union was 16 (range, 12 to 40) weeks. There was no loss of function of more than 10% compared to the healthy hand in the cases with full union. Postoperative mean grip strength was 37.3±3.0 kg. The rates of excellent and good results were 61.5%, moderate and poor results were 38.5% according to the Herbert-Fisher classification and the mean Mayo score was 80±13.
  
  
  CONCLUSIONS
  We obtained no satisfactory results in patients treated with non-vascularized bone grafting and screw fixation for proximal scaphoid non-unions. We suggest that grafting should be carried out in selected cases due to the adverse effects of open techniques and bone grafting on vascularity of scaphoid bone.
authors.affiliation: Department of Orthopedics and Traumatology, Medical Faculty of Ondokuz Mayıs University, 55139 Kurupelit, Samsun, Turkey. piskinahmet@gmail.com.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Pişkin
authors.forename: Alper
authors.initials: A
authors.lastname: Cıraklı
authors.forename: Murat
authors.initials: M
authors.lastname: Erdoğan
authors.forename: Hasan
authors.initials: H
authors.lastname: Göçer
authors.forename: Muhittin
authors.initials: M
authors.lastname: Sener
mesh_terms: D000328:Adult; D001863:Bone Screws; D016025:Bone Transplantation / Q000379:methods*; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D005599:Fractures, Ununited / Q000175:diagnosis / Q000601:surgery; D006225:Hand / Q000601:surgery; D018737:Hand Strength; D006801:Humans; D008297:Male; D011184:Postoperative Period; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D021361:Scaphoid Bone / Q000293:injuries / Q000601:surgery; D014182:Transplantation, Autologous / Q000379:methods; D016896:Treatment Outcome