Arthroscopic treatment of stable nonunion, unstable nonunion, or nonunion of the scaphoid with early degenerative radioscaphoid arthritis
Abstract Background This study was designed to analyze the clinical follow-up results (minimum of 2 years) in patients with stable nonunion, unstable nonunion, or nonunion of the scaphoid with early degenerative radioscaphoid arthritis (Lichtman classification stage I–III) treated with arthroscopic...
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| Format: | Article |
| Language: | English |
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BMC
2023-02-01
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| Series: | Journal of Orthopaedic Surgery and Research |
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| Online Access: | https://doi.org/10.1186/s13018-023-03609-8 |
| _version_ | 1827983264953925632 |
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| author | Yin-chuan Shih Chang-Chin Wu Jui-Tien Shih |
| author_facet | Yin-chuan Shih Chang-Chin Wu Jui-Tien Shih |
| author_sort | Yin-chuan Shih |
| collection | DOAJ |
| description | Abstract Background This study was designed to analyze the clinical follow-up results (minimum of 2 years) in patients with stable nonunion, unstable nonunion, or nonunion of the scaphoid with early degenerative radioscaphoid arthritis (Lichtman classification stage I–III) treated with arthroscopic osteosynthesis with autogenous bone graft. Methods We retrospectively recruited 44 consecutive patients with scaphoid fracture nonunion treated with arthroscopy-assisted percutaneous internal fixation with autogenous bone grafts from January 2010 to November 2019. We recorded union and return to activity and analyzed data with regular clinical follow-up at a mean duration of 33 months (range 24–46 months). Clinical (i.e., visual analog scale pain score, grip strength, and range of motion), radiographic, and functional (Mayo Modified Wrist Score (MMWS)) outcomes at the final follow-up were compared with the preoperative assessments and analyzed in patients with different stages. Results We confirmed union in 39 of the 44 patients (88.6%) after a mean 15.4 weeks post-operatively according to clinical examinations and standard radiography. All clinical parameters improved significantly. For the MMWS, there were 25 excellent and 14 good results. Of the 44 patients, 40 (90.9%) returned to work or sports activities at their preinjury levels. Comparisons of the outcomes between patients in different stages of scaphoid nonunion revealed no significant difference in the aspect of union rate, VAS pain score, and functional score improvement. Conclusions Arthroscopic osteosynthesis with autogenous bone grafts is a reliable and minimally invasive method for achieving nonunion healing and improving clinical outcomes in stage I–III scaphoid nonunion. Level of Evidence: Level IV, case series. |
| first_indexed | 2024-04-09T22:45:57Z |
| format | Article |
| id | doaj.art-7897bc3ebb8d414f8d91d02944ddc7e5 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-09T22:45:57Z |
| publishDate | 2023-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-7897bc3ebb8d414f8d91d02944ddc7e52023-03-22T11:51:40ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2023-02-0118111010.1186/s13018-023-03609-8Arthroscopic treatment of stable nonunion, unstable nonunion, or nonunion of the scaphoid with early degenerative radioscaphoid arthritisYin-chuan Shih0Chang-Chin Wu1Jui-Tien Shih2Department of Orthopaedic Surgery, En Chu Kong HospitalDepartment of Orthopaedic Surgery, En Chu Kong HospitalDepartment of Orthopaedic Surgery, Armed Forces Taoyuan General HospitalAbstract Background This study was designed to analyze the clinical follow-up results (minimum of 2 years) in patients with stable nonunion, unstable nonunion, or nonunion of the scaphoid with early degenerative radioscaphoid arthritis (Lichtman classification stage I–III) treated with arthroscopic osteosynthesis with autogenous bone graft. Methods We retrospectively recruited 44 consecutive patients with scaphoid fracture nonunion treated with arthroscopy-assisted percutaneous internal fixation with autogenous bone grafts from January 2010 to November 2019. We recorded union and return to activity and analyzed data with regular clinical follow-up at a mean duration of 33 months (range 24–46 months). Clinical (i.e., visual analog scale pain score, grip strength, and range of motion), radiographic, and functional (Mayo Modified Wrist Score (MMWS)) outcomes at the final follow-up were compared with the preoperative assessments and analyzed in patients with different stages. Results We confirmed union in 39 of the 44 patients (88.6%) after a mean 15.4 weeks post-operatively according to clinical examinations and standard radiography. All clinical parameters improved significantly. For the MMWS, there were 25 excellent and 14 good results. Of the 44 patients, 40 (90.9%) returned to work or sports activities at their preinjury levels. Comparisons of the outcomes between patients in different stages of scaphoid nonunion revealed no significant difference in the aspect of union rate, VAS pain score, and functional score improvement. Conclusions Arthroscopic osteosynthesis with autogenous bone grafts is a reliable and minimally invasive method for achieving nonunion healing and improving clinical outcomes in stage I–III scaphoid nonunion. Level of Evidence: Level IV, case series.https://doi.org/10.1186/s13018-023-03609-8Scaphoid nonunionWrist arthroscopyScaphoid nonunion advanced collapse (SNAC) |
| spellingShingle | Yin-chuan Shih Chang-Chin Wu Jui-Tien Shih Arthroscopic treatment of stable nonunion, unstable nonunion, or nonunion of the scaphoid with early degenerative radioscaphoid arthritis Journal of Orthopaedic Surgery and Research Scaphoid nonunion Wrist arthroscopy Scaphoid nonunion advanced collapse (SNAC) |
| title | Arthroscopic treatment of stable nonunion, unstable nonunion, or nonunion of the scaphoid with early degenerative radioscaphoid arthritis |
| title_full | Arthroscopic treatment of stable nonunion, unstable nonunion, or nonunion of the scaphoid with early degenerative radioscaphoid arthritis |
| title_fullStr | Arthroscopic treatment of stable nonunion, unstable nonunion, or nonunion of the scaphoid with early degenerative radioscaphoid arthritis |
| title_full_unstemmed | Arthroscopic treatment of stable nonunion, unstable nonunion, or nonunion of the scaphoid with early degenerative radioscaphoid arthritis |
| title_short | Arthroscopic treatment of stable nonunion, unstable nonunion, or nonunion of the scaphoid with early degenerative radioscaphoid arthritis |
| title_sort | arthroscopic treatment of stable nonunion unstable nonunion or nonunion of the scaphoid with early degenerative radioscaphoid arthritis |
| topic | Scaphoid nonunion Wrist arthroscopy Scaphoid nonunion advanced collapse (SNAC) |
| url | https://doi.org/10.1186/s13018-023-03609-8 |
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