Arthroscopic Matti-Russe Procedure

Abstract

Submit Manuscript | http://medcraveonline.com Avascular necrosis occurs in about 3% of cases, predominantly in the proximal pole. There are a number of techniques described with different types of grafts (vascularized and non-vascularized). Matti1 in 1936 developed the technique in which by dorsal approach it crossed the proximal and distal fragments of the scaphoid and filled with spongy bone graft. Russe 2 modified the Matti technique when using the via volar to preserve the vascularization of the scaphoid and to fill with sponge graft in a single block.The purpose of this technical note is to describe the modified Matti-Russe procedure performed by arthroscopic route and percutaneous volar screw fixation. Technical NoteCase report on a 21-year-old patient with scaphoid neck pseudarthrosis with three years of evolution and with an MRI that does not reveal avascular necrosis of the proximal pole ( Figures 1 & 2).The patient was placed in the supine position with a club at the root of the arm. The anesthestic technique was loco-regional block. Than, the arthroscopic arthroscopy system was assembled with 6Kg traction (Figure 3).The arthroscopic procedure started with the realization of standard radio-carpic initial portals; medium-carpal portals helped with the identification of the pseudarthrosis focus (Figure 4). The pseudarthrosis focus was blown out ( Figures 5 & 6). The spongious graft of the contralateral iliac crest was harvested. Placement of the graft through the midcarpal portal of visualization by adapting the arthroscopy trocar ( Figures 7-9). The traction was withdrawn. The graft was fixated with a percutaneous anterior approach and arthroscopic support and placement of the double compression screw with radiographic support (Figure 10). AbstractOpen surgical treatment with a bone graft is considered the gold standard for the treatment of scaphoid pseudarthrosis. Arthroscopic bone fixation with bone graft placement is a minimally invasive method, which is effective and with few associated complications. To describe an arthroscopic technique for the treatment of scaphoid pseudarthrosis. The arthroscopic treatment of stable scaphoid pseudarthrosis is an effective alternative to conventional open treatment.