Pseudarthrosis of the Carpal Scaphoid Treated with Non-Vascularized Corticocancellous Bone Graft
Objectives: To carry out an epidemiological study and to assess the evolutionary profile of patients with scaphoid non-union treated by anterior non-vascularized corticocancellous bone graft.
Introduction: The non-union is a serious complication of carpal scaphoid fractures. Untreated, it leads to instability and osteoarthritis of the carp. The most used technique is that of Matti-Russe employing a corticocancellous graft.
Materials and methods: We report in this retrospective study the experience of the department of Orthopaedic Surgery & Traumatology II, Mohamed V Military Hospital, Rabat, in the treatment of non-unions of the carpal scaphoid by anterior non-vascularized corticocancellous graft in nine cases collected between January 2012 and March 2016. We identified six cases of stage IIA and three cases of stage IIB. All our patients were operated by the Matti-Russian technique followed by an immobilization by plaster cast cuff on three months.
Results: All our patients achieved a union within an average of three months. The Mayo Wrist score was excellent in 66.6% of cases. Our results were very satisfying in 90% of cases, satisfying in 10%.
Conclusion: The treatment of non-unions of the carpal scaphoid without necrosis or osteoarthritis, using anterior non-vascularized bone graft remains the most widely used technique. The presence of initial instability is a factor of poor prognosis, its correction reduces the risk of arthritis.
Bellec Y. Le, Alnot J-Y. Treatment of non-unions of the carpal scaphoid using a nonvascularised corticocancellous bone graft: A retrospective series of 47 cases. Chirurgie de la main. 2008; 27: 154-159. DOI: https://doi.org/10.1016/j.main.2008.07.007 [PMid:18771944]
Matti H. Technik und resultate meiner pseudarthrosen-operation. Z chir. 1936; 63:1442-1453.
Russe O. Fractures of the carpal navicular. Diagnosis, non-operative treatment, and operative treatment. J Bone Joint Surg. 1960; 42 A: 759-768.
Michon J. Fractures and pseudarthroses of the carpal scaphoid, Rev Chir Orthop. 1972; 58:649-815.
Passuti N, Waast D, Pietu G, Gouin F. Complications of bone consolidation: nonunion, Revue de chirurgie orthopédique et traumatologique. 2004 ; 90 (5), 160. doi : RCO-09-2004-90-S5-0035-1040-101019-ART178.
Herbert TJ, Fischer WE. Management of the fractured scaphoid using a new bone screw. J Bone Joint Surg Br. 1984; 66:114-123. DOI: https://doi.org/10.1302/0301-620X.66B1.6693468 [PMid:6693468]
Idou O, Martin B, Gomis R. Retrospective study of a series of thirty-three pseudarthroses of the carpal scaphoid by intervention of Matti-Russe. La Main. 1996; 1:291-298.
Bellemère Ph. Pseudarthrosis of the carpal scaphoid: Spongy graft and pinning. Sauramps medical. 2004;247–53
Hooning Van Duyvenbode JF, Keijser LC, Hauet EJ, Obermann WR, Rozing PM. Pseudarthrosis of the scaphoid treated by the Matti-Russ operation. J Bone Joint Surg. 1991;73B:603–6. DOI: https://doi.org/10.1302/0301-620X.73B4.2071643
Jiraneck WA, Ruby K, Millender LB, Banroff MS, Newberg AH. Long term results after Russe bone grafting: the effect of mal-union of the scaphoid. J Bone Joint Surg. 1992;74A:8–16.
Nakamura R, Imadea T, Tsuge S, Watanabe K. Scaphoid non-union with DISI deformity. J Hand Surg. 1991;16B:156–61. DOI: https://doi.org/10.1016/0266-7681(91)90167-M
Huene DR, Huene DS. Treatment of nonunion of the scaphoid with the Ender compression blade plate system. J Hand Surg [Am]. 1991;16:913–22. DOI: https://doi.org/10.1016/S0363-5023(10)80160-1
Tomaino MM, King J, Pizillo M. Correction of lunate malalignement when bone grafting scaphoid nonunion with humpback deformity: rational and results of a technique revisited. J. Hand Surg [Am]. 2000;25:322–9. DOI: https://doi.org/10.1053/jhsu.2000.jhsu25a0322 [PMid:10722825]
Linscheid RL, Dobins JH, Cooney WP. Volar wedge grafting of the carpal scaphoid in non-unions associated with dorsal instability patterns. J Bone Joint Surg. 1982;64:632–3.
Copyright (c) 2018 Omar Mourafiq, Valery Kamenan, Youssef Benyias, Jalal Boukhriss, Bouchaib Chefry, Driss Bencheba, Ahmed Salim Bouabid, Moustapha Boussouga
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