Arthroscopically assisted Cancellous Bone Grafting and Percutaneous K-Wires Fixation for the Treatment of Scaphoid Nonunions

Lee,  Young Keun; Woo,  Sang Hyun; Ho,  Pak Cheong; Park,  Ji Gang; Kim,  Joo Yong

doi:2014.19.1.19

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Original Article

Journal of the Korean Society for Surgery of the Hand 2014;19(1):19-28.
Published online March 30, 2014.
DOI: https://doi.org/10.12790/jkssh.2014.19.1.19

Arthroscopically assisted Cancellous Bone Grafting and Percutaneous K-Wires Fixation for the Treatment of Scaphoid Nonunions

Young Keun Lee, Sang Hyun Woo, Pak Cheong Ho, Ji Gang Park, Joo Yong Kim

¹Department of Orthopaedic Surgery, Dason Orthopaedic Clinic, Jeonju, Korea.
²Chen and Woo's Institute for Hand Surgery and Reconstructive Microsurgery, W Hospital, Daegu, Korea.
³Department of Orthopaedic and Traumatology, Prince of Wales Hospital, Chinese University, Hong Kong.
⁴Department of Orthopaedic Surgery, Chungbuk National Universiry Hospital, Chungbuk National University College of Medicine, Chungju, Korea.
⁵Department of Orthopaedic Surgery, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea. trueyklee@naver.com

Received: 2 January 2014 • Revised: 21 February 2014 • Accepted: 28 February 2014

Abstract

Purpose
The purpose of this study was to analyze the clinical results of patients with scaphoid nonunions treated with arthroscopically assisted bone grafting and percutaneous K-wires fixation.

Methods
We retrospectively reviewed 20 patients with a scaphoid nonunions which was treated with arthroscopically assisted bone grafting and percutaneous K-wires fixation from November 2008 to July 2012. Time from injury to treatment was 74 months (range, 3-480 months) in average. Functional outcome was evaluated using the modified Mayo wrist score and visual analogue scale (VAS) for pain, which were measured before operation and at the last follow up.

Results
All nonunions were healed successfully. The average radiologic union time was 9.7 weeks (range, 7-14 weeks). The average VAS score improved from 6.3 (range, 4-8) preoperatively to 1.6 (range, 0-3) at the last follow up. The average modified Mayo wrist score increased from 62.5 preoperatively to 85.7 at the last follow-up.

Conclusion
Arthroscopically assisted bone grafting and percutaneous K-wires fixation is an effective treatment method for a scaphoid nonunion. It may provide more biological environment than open surgery as a minimally invasive procedure.

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