The natural history of scaphoid non-union. A review of fifty-five cases.

Ruby, Leonard K.; Stinson, Jennifer; Belsky, Mark R.

doi:10.2106/00004623-198567030-00013

Cited by 299 publications

(117 citation statements)

References 2 publications

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“…This deformity can often be improved by surgery, although soft-tissue and capsular contractures sometimes preclude complete correction in late cases (type D3). We therefore believe that the policy of operating early for nonunion, even when it is asymptomatic, is fully justified; there is good evidence that untreated nonunion of the scaphoid leads to progressive arthritis and ischaemia (Mack et al 1984;Ruby, Stinson and Belsky 1985;Lindstrom and Nystrom 1992;Shinya and Herbert 1994). Complications.…”

Section: Discussionmentioning

confidence: 99%

Herbert Screw Fixation of Scaphoid Fractures

Filan

Herbert

1996

The Journal of Bone and Joint Surgery. British volume

291

190

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On average, patients returned to work 4.7 weeks after surgery and wrist function was significantly improved, even when the fracture failed to unite. Healing rates for acute fractures were better than those reported for plaster immobilisation and were independent of fracture location. In the case of established nonunions, healing depended on the stage and location of the fracture, but the progress of arthritis was halted and carpal collapse significantly improved.Internal fixation of the scaphoid using the Herbert bone screw, although technically demanding, has few complications and appears to offer significant advantages over other methods of treatment.

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Section: Discussionmentioning

confidence: 99%

Herbert Screw Fixation of Scaphoid Fractures

Filan

Herbert

1996

The Journal of Bone and Joint Surgery. British volume

291

190

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“…2 If left untreated, SN leads to scaphoid non-union advanced collapse and osteoarthritis in more than 90% of cases after 10 years. [3][4][5] Various non-vascularized and vascularized cortico-spongious bone grafts are employed to treat SN. [6][7][8] Recently, vascularized bone grafts, such as the 1,2-intercompartmental supraretinacular artery pedicled vascularized bone graft (1,2-ICSRA-VBG), 9 the free femoral condyle, [10][11][12] and the free iliac crest bone graft 13 have become increasingly popular in the treatment of SN.…”

Section: Introductionmentioning

confidence: 99%

Vascularized versus non-vascularized bone grafts in the treatment of scaphoid non-union

Hirche

Xiong

Heffinger

et al. 2017

J Orthop Surg (Hong Kong)

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Introduction: Conventional non-vascularized bone grafts as well as vascularized bone grafts are used to treat scaphoid non-union (SN). Due to limited available studies, the field of application using both grafts for SN still remains controversial. The aim of this study was to evaluate a treatment algorithm for the use of both vascularized versus non-vascularized bone grafts based on clinical outcomes and quality of life (QoL) to improve the level of evidence. Materials and Methods: Based on a retrospective cohort study, including 28 patients with vascularized and 45 patients with conventional bone grafts, functional parameters, radiological outcome, Mayo-wrist-score, and QoL by SF-36 were applied to statistically compare the outcome of these two techniques. Results: Time between last procedure or trauma and study group scaphoid reconstruction was almost double in the vascularized bone grafting group. Comparable union rates were achieved with vascularized as well as non-vascularized bone grafts. Significant differences were observed between both groups for grip strength and radial-ulnar active range of motion. Further functional outcomes, radiological outcomes as well as QoL were found similar for both techniques in patients with surgical union. Discussion and conclusions: In order to achieve comparable and appropriate treatment results, vascularized bone grafts are recommended for patients with delayed treatment, impaired scaphoid vascularity, and revision surgery. Even in preselected, complex cases, the results are comparable to conventional grafts, which are the basis for further patient education and approve the powerful role of surgical angiogenesis of vascularized bone grafts.

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“…A number of studies have shown that long-standing non-union appears to predispose to progressive arthrosis of the intercarpal joints (Ruby et al 1985, Vender et al 1987. In an attempt to prevent such change, early operative intervention with grafting plus or minus internal fixation for unstable scaphoid fractures is advocated by a number authors (Herbert andFisher 1984, Leyshon et al 1984).…”

Section: Discussionmentioning

confidence: 99%