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Journal of the Korean Society for Surgery of the Hand 2003;8(3):108-114.
Published online September 1, 2003.
Treatment of Scaphoid Nonunion with Inlay Bone Graft
Bo-Kyu Yang, Sung-Ho Hahn, Seung-Rim Yi, Shun-Wook Chung, Dong-Ho Lee, Ji-Hyun Seo
내재 골 이식술을 이용한 주상골 불유합의 치료
양보규, 한성호, 이승림, 정선욱, 이동호, 서지현
Abstract
Purpose
To evaluate the clinical presentation and the opeartive treatment results of inlay bone graft in the nonunion of the scaphoid fracture. Materials and Methods: We evaluated 41 patients (42 cases) of the scaphoid nonunion treated by inlay bone graft from February 1992 to February 2001. Additional K-wire fixation was needed in 10 cases. The most common injury mechanism was fall on the outstretched hand (33 cases: 78.6%). The average follow-up period was 23.2 months (range, 12-62). Preoperative Xray was examined for bony sclerosis, gap, and absorption of fracture line, and postoperative X-ray was examined for bony union, and correction of the scapholunate angle. The location of fracture was waist in 41 cases, and poximal 1/3 in 1 case. The clinical results were classified as excellent, good, fair, poor by Maudsley and Chen’s method. The duration of postoperative immobilization was from 2 to 3 months. Results: The scapholunate angle decreased from a mean of 69.4°(range, 52-116) preoperatively to 45.6° (range, 43-69) postoperatively. There was radiological bony union in 39 cases (93%) out of 42, and the average time to radiological bony union was 4.29 months. According to Maudsley and Chen’s method, the results revealed as excellent in 12, good in 22, fair in 5 cases, showing more than good results in 81%. Conclusion: Inlay bone graft for the treatment of the scaphoid nonunion shows radiological bony union in 93%, and more than good results in 81%. Inlay bone graft alone could be a useful method in treatment of the scaphoid nonunion.
 


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