Beyond elimination of pain, the objective of surgical treatment of scaphoid pseudarthrosis is the prevention of otherwise inevitable arthrosis of the wrist. In a follow-up of twenty-five patients over at least ten years post-operatively, the rate of union, but above all, the development of carpal instability and arthrosis was investigated. In the healed scaphoid, instability did not increase, although signs of arthrosis were found in almost all patients. As a rule, the degree of arthrosis was more pronounced in those cases with persisting subluxation of the lunate and DISI pattern of instability. Consequently, simultaneous correction of lunate subluxation via ligament reconstruction must be recommended when scaphoid pseudarthrosis is to be treated effectively. Late results of this modified procedure are not yet available though.