title: Treatment of Proximal Scaphoid Non-union by Resection of the Proximal Pole and Palmaris Longus Interposition Arthroplasty.
abstract: BACKGROUND
  The purpose of this study was to determine the long-term clinical and radiographic outcome in a group of patients treated with resection of the proximal pole and tendon ball arthroplasty because of a scaphoid non-union.
  
  
  METHODS
  15 patients affected by scaphoid non-union and treated with resection arthroplasty were studied at a mean follow-up of 9.1 years. The assessment included a visual analogue scale (VAS) to evaluate pain, the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, and the measurement of grip and pinch strength. We also evaluated pre-operative and follow-up radiographs to determine the stage of SNAC wrist.
  
  
  RESULTS
  We obtained a good subjective clinical result in 11 patients and a poor result in 4. Mean VAS and DASH score at follow-up was 1.2±1.2 and 12±12,1, respectively. Grip and key pinch strength in the surgically treated hand were 89% of the contralateral hand. There was significant increase in the SNAC stage at follow-up with respect to the preoperative evaluation in the operated wrist.
  
  
  CONCLUSIONS
  Resection of the proximal pole and tendon ball arthroplasty provided long-term relief of pain and good functional results in most patients affected by scaphoid non-union. This technique did not affect the natural history of SNAC wrist with its clinical and functional consequences.
authors.affiliation: Department of Orthopaedic Surgery, University Federico II, Napoli, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Smeraglia
authors.affiliation: Department of Orthopaedic Surgery, University Federico II, Napoli, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Ciaramella
authors.affiliation: Department of Orthopaedic Surgery, University Federico II, Napoli, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Cerbasi
authors.affiliation: Department of Orthopaedic Surgery, University Federico II, Napoli, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Balato
authors.affiliation: Department of Orthopaedic Surgery, University Federico II, Napoli, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Mariconda
mesh_terms: D000328:Adult; D000368:Aged; D001178:Arthroplasty / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005599:Fractures, Ununited / Q000601:surgery*; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D017060:Patient Satisfaction; D052581:Pinch Strength / Q000502:physiology; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D011542:Pseudarthrosis / Q000601:surgery*; D012086:Reoperation; D021361:Scaphoid Bone / Q000293:injuries* / Q000601:surgery*; D013710:Tendons / Q000637:transplantation*; D055815:Young Adult