Non-Union of the Scaphoid Treated with Styloidectomy and Compression Screw Fixation

Abstract

17 patients were re-examined 13 to 19 years (mean 16 years) after operation for non-union of the scaphoid. A standardized method including styloidectomy and compression screw fixation according to McLaughlin was used. The mean interval between trauma and operation was 34 months. All patients were male and the mean age at surgery was 31 years. Bone union was obtained in 65% (11/17) and radio-carpal arthrosis was found in 83% (14/17) compared with 41% (7/17) at the time of operation. Impaired motion as well as marked decrease in strength was noted in comparison with the healthy side. 88% of the patients were satisfied with the result. All returned to and continued in their previous occupation. The McLaughlin method proved to be clinically beneficial in spite of a relatively high percentage of persistent non-unions.

Scaphoid nonunion in the presence of a degenerate carpus: don’t rush to salvage surgery

“…When arthritis is restricted to the tip of the styloid, good results can be achieved with bone grafting, fixation and a radial styloidectomy (Brostrom et al, 1986). Some surgeons may extend this treatment to those patients with SNAC II disease (Munk and Larsen, 2004; Reigstad et al, 2010).…”

Screw Fixation Alone for Scaphoid Fracture Nonunion

“…Several groups in the 1970s and 1980s achieved union rates of 65% to 80% in patients treated with screw or Kirschner wire fixation alone. 4,33,35 Herbert and Fisher 24 achieved union in 88.2% of fibrous nonunions despite using bone graft in just 23.7% of those cases.…”

The late consequences of scaphoid fractures

“…The screw did not enter the scaphotrapezial joint, being introduced into the distal fragment from the radial side through a dorsoradial approach. Broström, Stark and Svartengren 35 made this procedure easier by removing the radial styloid. They examined 17 patients 13 to 19 years later.…”