Arthroscopic Treatment of Stable Scaphoid Nonunion

Abstract

Background: Open bone grafting has been the standard procedure for treatment of scaphoid nonunion. Arthroscopic bone grafting and fixation is a minimally invasive method, which is effective as open procedure with minimal complications.
Objectives: The purpose of this study was to assess the results of arthroscopic treatment by refreshing and bone grafting on clinical wrist function and radiographic outcome in patients with stable scaphoid nonunion.
Patients and Methods: Between June 2012 and May 2014, 17 patients received arthroscopic refreshing and bone grafting for treatment of stable waist scaphoid nonunion. The mean follow-up was 13 months (ranged 6 - 18 months).
Results: The mean flexion/extension of the wrist was 72 degrees (ranged 50 - 160 degrees) compared with the pre-operation 53 degrees (ranged 35 - 160 degrees) (P < 0.04). Grip strength at final follow-up averaged 28 kg (ranged 12 - 455 kg) indicating a significant improvement from 21kg (ranged 5 - 41 kg) before the operation (P < 0.026). The mean Quick DASH scores showed a significant improvement from 48 (ranged 27 - 90) preoperatively to 84 (ranged 76 - 100) postoperatively (P < 0.05). The mean VAS score showed a significant improvement from 4.3 (ranged 2 - 7) preoperatively to 1.03 (ranged 0 - 4) postoperatively (P < 0.04).
Conclusions: Arthroscopic treatment of stable scaphoid nonunion is an effective alternative to the conventional treatment of stable Scaphoid nonunion.