Percutaneous Fixation without Bone Graft for Scaphoid Nonunion. 2020

João Carlos Belloti, and Klebson Bruno Lopes Vasconcelos, and Jorge Raduan Neto, and Aldo Okamura, and Marcela Fernandes, and Vinícius Ynoe de Moraes
Serviço de Cirurgia da Mão, Hospital Alvorada, United Health, São Paulo, SP, Brasil.

Objective  To describe the clinical and radiographic outcomes of patients submitted to percutaneous fixation without bone graft for scaphoid nonunion, with a minimum follow-up of six months. Methods  A case series study of a convenience sample of hand surgeons with prospective evaluation. Patients with scaphoid (waist or proximal pole) nonunion and the following features were included: more than six months of history; X-rays showing sclerosis of the edges of the nonunion, with resorption of the nonunion focus measuring less than 4 mm (Slade & Gleissler I, II, III and IV) and no angular deformity; and no proximal pole necrosis on magnetic resonance imaging (MRI). Results  After six months of follow-up, all nonunion were consolidated, with no major complications. The functional outcomes revealed good scores on the disabilities of the arm, shoulder and hand (DASH; n = 12; mean: 6.9; standard deviation [SD]: 2.1) and patient-rated wrist evaluation (PRWE; n = 12; mean: 7.97, SD: 1.5) questionnaires. The results of the visual analog scale (VAS) showed little residual pain (n = 12; mean: 0.71; SD: 0.2). Slight decreases in flexion (69 versus 59.1; p  = 0.007), extension (62.4 versus 48.7; p  = 0.001) and radial deviation (29.6 versus 24.6; p  = 0.014) were detected in comparison to the contralateral side. Conclusions  All cases in the series presented consolidation and good functional scores at the six-month evaluation. This is a promising option (with lower technical demand and morbidity) for the treatment of scaphoid nonunion. Comparative studies are required to assess the effectiveness of this technique in comparison with other options.

UI MeSH Term Description Entries

Related Publications

João Carlos Belloti, and Klebson Bruno Lopes Vasconcelos, and Jorge Raduan Neto, and Aldo Okamura, and Marcela Fernandes, and Vinícius Ynoe de Moraes
July 2011, The Journal of bone and joint surgery. British volume,
João Carlos Belloti, and Klebson Bruno Lopes Vasconcelos, and Jorge Raduan Neto, and Aldo Okamura, and Marcela Fernandes, and Vinícius Ynoe de Moraes
December 2008, The Journal of trauma,
João Carlos Belloti, and Klebson Bruno Lopes Vasconcelos, and Jorge Raduan Neto, and Aldo Okamura, and Marcela Fernandes, and Vinícius Ynoe de Moraes
February 2021, Journal of clinical orthopaedics and trauma,
João Carlos Belloti, and Klebson Bruno Lopes Vasconcelos, and Jorge Raduan Neto, and Aldo Okamura, and Marcela Fernandes, and Vinícius Ynoe de Moraes
September 2015, Hand (New York, N.Y.),
João Carlos Belloti, and Klebson Bruno Lopes Vasconcelos, and Jorge Raduan Neto, and Aldo Okamura, and Marcela Fernandes, and Vinícius Ynoe de Moraes
March 2018, Nigerian journal of clinical practice,
João Carlos Belloti, and Klebson Bruno Lopes Vasconcelos, and Jorge Raduan Neto, and Aldo Okamura, and Marcela Fernandes, and Vinícius Ynoe de Moraes
March 2003, Techniques in hand & upper extremity surgery,
João Carlos Belloti, and Klebson Bruno Lopes Vasconcelos, and Jorge Raduan Neto, and Aldo Okamura, and Marcela Fernandes, and Vinícius Ynoe de Moraes
March 2018, The journal of hand surgery Asian-Pacific volume,
João Carlos Belloti, and Klebson Bruno Lopes Vasconcelos, and Jorge Raduan Neto, and Aldo Okamura, and Marcela Fernandes, and Vinícius Ynoe de Moraes
September 2021, The Journal of hand surgery, European volume,
João Carlos Belloti, and Klebson Bruno Lopes Vasconcelos, and Jorge Raduan Neto, and Aldo Okamura, and Marcela Fernandes, and Vinícius Ynoe de Moraes
November 2001, Hand clinics,
João Carlos Belloti, and Klebson Bruno Lopes Vasconcelos, and Jorge Raduan Neto, and Aldo Okamura, and Marcela Fernandes, and Vinícius Ynoe de Moraes
March 1995, The Journal of hand surgery,
Copied contents to your clipboard!