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Treatment of Scaphoid Non-Unions of the Proximal third with Conventional Bone Grafting and Mini-Herbert Screws: an Analysis of Clinical and Radiological Results

From the Department of Hand-, Plastic and Reconstructive Surgery, Burn Center, BG – Trauma Center Ludwigshafen, Plastic and Hand Surgery of the University of Heidelberg, Germany

Correspondence: Kai Megerle, MD, Department of Hand-, Plastic and Reconstructive Surgery, Burn Center, BG – Trauma Center Ludwigshafen, Plastic and Hand Surgery of the University of Heidelberg, Ludwig-Guttmannstr. 13, 67071 Ludwigshafen, Germany. Tel.: +49 621 6810 2944; fax: +49 621 6810 2844. E-mail: megerle{at}bgu-ludwigshafen.de.

This study assessed the clinical and radiological outcomes after treatment of scaphoid non-union of the proximal third by non-vascularised bone grafts and stabilisation by Mini-Herbert Screws from a dorsal approach. Thirty-one patients, one woman and 30 men, were reviewed retrospectively at a mean of 42 (12–77) months. All patients received pre- and postoperative CT scans to assess bone union. In addition to demographic data, the range of motion, grip strength, DASH score, Krimmer score, Mayo wrist score and radiological parameters (carpal height, scapholunate and radiolunate angles) were recorded. Bone union was achieved in 21 patients. The average DASH score in patients with bone union was 12 and that in patients with persistent non-union it was 30. No progression into carpal collapse or increase of scapholunate angles was detected. Our study demonstrates that acceptable union rates can be achieved with non-vascularised bone grafts, and this technique compares favourably with other reports in the literature.

Key Words: scaphoid • nonunion • Herbert Screw • bone graft

Journal of Hand Surgery (European Volume), Vol. 33, No. 2, 179-185 (2008)
DOI: 10.1177/1753193408087030


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