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Journal of Hand Surgery (British and European Volume)
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Articles

Repeat Russe Bone Grafting after Failed Bone Graft Surgery for Scaphoid Non-Union

E. B. BYNUM
R. W. CULP
T. J. BONATUS
C. E. ALEXANDER
H. R. McCARROLL

From the Department of Orthopaedic Surgery, Naval Medical Centre, Oakland and the Department of Hand Surgery, California Pacific Medical Centre, San Francisco, California, USA

Correspondence: E.B. Bynum, Department of Orthopaedic Surgery, Naval Hospital Charleston, 3600 Rivers Avenue, North Charleston, SC 29405-7744, USA.

We report the long-term outcome of repeat Russe bone grafting after failure of a previous Russe graft for scaphoid non-union. 15 patients were followed for a mean of 71 months after their last surgical procedure. 11 patients had undergone a single previous Russe graft and four patients had two previous graft attempts. Internal fixation was used in only three patients. Eight out of 15 (53%) patients achieved union after a single repeat graft and one out of four united after a third attempt. When union was achieved, range of motion was unchanged, grip strength was increased 10%, and pain was slight to none, allowing return to full employment in seven out of the nine patients. All patients who did not achieve union have either undergone a salvage procedure or are contemplating one. Based on the literature and our relatively low rate of union without internal fixation (53%), we recommend supplementary internal fixation if repeat Russe bone grafting is undertaken. When union is achieved, satisfactory results can be expected.

Journal of Hand Surgery (British and European Volume), Vol. 20, No. 3, 373-378 (1995)
DOI: 10.1016/S0266-7681(05)80096-8
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