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Unstable Scaphoid Nonunion Treatment Technique: Use of a Volar Distal Radius Corticocancellous Autograft

Reed, Dale Nicholas MD*; Fulcher, Simeon Marcus MD*; Harrison, Steven J. PhD, CMI

Techniques in Hand & Upper Extremity Surgery: June 2012 - Volume 16 - Issue 2 - p 91–94
doi: 10.1097/BTH.0b013e31824cc258
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Scaphoid nonunions are challenging cases that first must be identified and then treated based on stability, collapse, and vascularity. Unstable nonunions are identified on the basis of collapse of the scaphoid into the “humpback” deformity with an increased intrascaphoid and scapholunate angles. The importance of restoring normal scaphoid alignment has been stressed, because failure to do so leads to worse clinical and radiographic results with predictable patterns of radiocarpal arthrosis. We present a technique to correct unstable scaphoid nonunions using a single volar-based incision with harvesting of volar distal radius corticocancellous autograft. This technique allows the avoidance of harvest site morbidity and has union rates comparable with the gold standard of iliac crest.

Departments of *Orthopaedic Surgery

Medical Illustration, Georgia Health Sciences University, Augusta, GA

Conflicts of Interest and Source of Funding: The authors report no conflicts of interest and no source of funding.

Address correspondence and reprint requests to Dale Nicholas Reed, MD, Department of Orthopaedic Surgery, Georgia Health Sciences University, 1120 15th Street, BP-2109, Augusta, GA 30912. E-mail: dreed@georgiahealth.edu.

© 2012 Lippincott Williams & Wilkins, Inc.