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Internal Bone Grafting for the Treatment of Scaphoid Nonunions

Aydin, Utkan MD; Thirkannad, Sunil M. MD

Techniques in Hand & Upper Extremity Surgery: March 2017 - Volume 21 - Issue 1 - p 18–21
doi: 10.1097/BTH.0000000000000137
Techniques
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Scaphoid fracture is the most common carpal fracture of the upper extremity and a significant proportion of these can eventually progress to nonunion. Excision of pseudoarthrosis and fibrous scar tissue at the nonunion site is regarded as one of the important steps in management of scaphoid nonunions. We describe a technique of internal bone grafting, where curettage of the nonunion site was performed through a drill hole in the scaphoid and bone graft was packed through this same hole before fixation with a headless compression screw. We have been able to achieve a union rate of 86% using this technique. The advantage of the technique is that it does not disturb the external fibrocartilaginous shell that would have formed around the nonunion site, thus leaving the articular surface undisturbed.

Christine M. Kleinert Institute for Hand and Microsurgery, Louisville, KY

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 Sunil M. Thirkannad, MD, Christine M. Kleinert Institute for Hand and Microsurgery, 225 Abraham Flexner Way, Suite 810, Louisville, KY 40202. E-mail: sthirkannad@kleinertkutz.com.

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