title: Ilizarov fixation for the treatment of scaphoid nonunion: a novel approach.
abstract: OBJECTIVE
  To evaluate the safety and efficacy of the Ilizarov fine-wire compression/distraction technique in the treatment of scaphoid nonunion (SNU), without the use of bone graft.
  
  
  METHODS
  This is a prospective study of 20 consecutive patients in one center.
  
  
  METHODS
  This study included 20 patients (19 males) with a mean SNU duration of 14.5 months. Four patients had proximal pole, 15 had waist, and 1 had a distal SNU. Patients with carpal instability, humpback deformities, carpal collapse, avascular necrosis, and marked degenerative change were excluded. Following frame application, the treatment comprises three stages: The frame is distracted by 1 mm per day until the radiographs show a 2-3 mm opening at the SNU site (mean 10 days); the SNU site is compressed for 5 days, at a rate of 1 mm per day, with the wrist in 15 degrees of flexion and 15 degrees of radial deviation; the wrist is then immobilized in the Ilizarov fixator for 8 weeks.
  
  
  RESULTS
  Radiographic (radiography and CT scan) and clinical bony union was achieved in all 20 patients after a mean of 90.3 days (70-130 days). All patients returned to their pre-injury occupations. Thirteen patients had excellent results, four good, and three fair, according to the Mayo wrist score.
  
  
  CONCLUSIONS
  In these selected patients, this technique safely achieved bony union without the need to open the SNU site and without the requirement of bone graft.
authors.affiliation: School of Medicine, Institute for Orthopaedic Surgery and Traumatology, Clinical Center of Serbia, University of Belgrade, Visegradska 26, 11000, Belgrade, Serbia. marko.bumbasirevic@gmail.com.
authors.forename: Marko
authors.initials: M
authors.lastname: Bumbaširević
authors.affiliation: School of Medicine, Institute for Orthopaedic Surgery and Traumatology, Clinical Center of Serbia, University of Belgrade, Visegradska 26, 11000, Belgrade, Serbia.
authors.forename: Tomislav
authors.initials: T
authors.lastname: Palibrk
authors.affiliation: Department of Trauma and Orthopaedics, North Middlesex University Hospital, Sterling Way, London, N18 1QX, UK.
authors.forename: Henry Dushan E
authors.initials: HD
authors.lastname: Atkinson
authors.affiliation: School of Medicine, Institute for Orthopaedic Surgery and Traumatology, Clinical Center of Serbia, University of Belgrade, Visegradska 26, 11000, Belgrade, Serbia.
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Lešić
mesh_terms: D000293:Adolescent; D000328:Adult; D004867:Equipment Design; D005260:Female; D017102:Fracture Healing / Q000502:physiology; D005599:Fractures, Ununited / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D018889:Ilizarov Technique; D008297:Male; D011446:Prospective Studies; D016059:Range of Motion, Articular; D021361:Scaphoid Bone / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
keywords: Ilizarov circular frame; Scaphoid nonunion; Without bone graft