title: Suture anchor fixation for scaphoid nonunions with small proximal fragments: report of 11 cases.
abstract: OBJECTIVE
  To describe the use of 2 suture anchors as the fixation devices in the management of 11 patients with scaphoid proximal pole nonunions with small proximal fragments.
  
  
  METHODS
  In a prospective study, 11 patients with proximal pole scaphoid nonunions (10 with small proximal fragments and 1 with an oblique nonunion line) were evaluated before surgery by standard wrist x-rays and functional wrist scores including a visual analog scale (VAS), Mayo wrist score, and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH). The nonunion site was fixed with 2 suture anchors supplemented with autologous cancellous bone graft. Postoperative evaluations consisting of functional wrist scores and evaluation of radiological union were performed 9 months after surgery.
  
  
  RESULTS
  At the end of the study, we observed union in 10 of the 11 patients. The QuickDASH and VAS scores showed significant improvement, and 10 patients had satisfactory Mayo scores.
  
  
  CONCLUSIONS
  We propose the technique of suture anchor fixation for cases of proximal scaphoid nonunion in which secure internal fixation with common techniques is challenging because of the small size of the proximal fragment and the obliquity of the nonunion site.
  
  
  METHODS
  Therapeutic IV.
authors: Department of Orthopedic and Trauma Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran; Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors: Reza Shahryar
authors: RS
authors: Kamrani
authors: Department of Orthopedic and Trauma Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran; Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: leila_zanjani@yahoo.com.
authors: Leila Oryadi
authors: LO
authors: Zanjani
authors: Department of Orthopedic and Trauma Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran; Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors: Mohammad Hossein
authors: MH
authors: Nabian
mesh_terms: D000328:Adult; D005593:Fracture Fixation, Internal / Q000295:instrumentation; D005599:Fractures, Ununited / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D021361:Scaphoid Bone / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D053441:Suture Anchors; D055815:Young Adult
keywords: Mayo wrist score; QuickDASH score; proximal pole nonunion; scaphoid nonunion; suture anchor