Clinical and Radiological Evaluation of Surgical Treatment Outcomes in Disturbances of Scaphoid Bone Fusion in a Pediatric Population.

Background/

Objectives

This study aimed to investigate the results of surgical intervention in cases of scaphoid nonunion and delayed healing among individuals aged 18 or younger, focusing on both clinical and radiological aspects, as well as identifying possible factors that may impact the effectiveness or failure of the treatment.

Methods

A total of 20 boys with impaired scaphoid bone healing underwent surgical treatment, with the average duration between the suspected injury and the procedure being approximately 10.8 months. At the time of surgery, the patients had a mean age of 15 years, and the average follow-up period was 20 months. We assessed the type of surgery performed, along with range of motion and pain intensity, comparing preoperative findings with those recorded at the final evaluation. Based on lateral X-ray examination, CLA (capitolunate angle), SCA (scaphocapitate angle), and SLA (scapholunate angle) angles were measured before and after surgery and at the last follow-up.

Results

The treatment results showed bone union in 18 out of 20 patients (90%), complete pain relief in 17 patients (85%), and a significant improvement in ROM. There was a statistically significant improvement in the SLA angle and an increase in wrist dorsal flexion. We also identified three factors that significantly influence better ROM after surgery, namely the values of the CLA and SLA angles, as well as the time from injury to surgery.

Conclusions

Our findings suggest that surgical intervention contributes to improved joint mobility, pain reduction, and restoration of anatomical alignment in the wrist. While we identified factors associated with more favorable functional results, we did not find any that were linked to a higher likelihood of treatment failure.