J Korean Soc Surg Hand.  2011 Jun;16(2):85-92.

Revision Osteosynthesis after Failed Surgery for Scaphoid Nonunion

• Jung M
• Choi YR
• Koh IH
• Kim YJ
• Kang HJ

Abstract

PURPOSE
The purpose of this study was to evaluate the outcomes of revision osteosynthesis using Herbert screw fixation combined with autogenous cancellous bone grafting for scaphoid nonunions after failed primary surgery.
MATERIALS AND METHODS
Twelve patients who underwent revision osteosynthesis for a scaphoid nonunion after a mean of 13.6 months following primary surgical failure were studied. There were 9 waist fractures and 3 proximal fractures. The revision osteosynthesis was performed using autogenous iliac cancellous bone grafting combined with Herbert screw fixation.
RESULTS
Union was achieved in 11 of 12 cases. The results of eleven united cases were clinically satisfactory at the mean follow up of 16.9 months after revision. The motion range of wrist joint improved: average flexion was 51degrees, average extension was 65degrees, average radial deviation 15degrees, and average ulnar deviation was 21degrees.
CONCLUSION
Herbert screw fixation and autogenous iliac cancellous bone grafting was proved to be a useful method as a revisional operation for a scaphoid nonunion after failed primary surgery.

Keyword

Scaphoid; Nonunion; Revisional surgery; Herbert screw; Bone grafting

MeSH Terms

Bone Transplantation
Follow-Up Studies
Humans
Wrist Joint