[Long-term outcome of partial prosthesis management of proximal scaphoid pseudarthroses with a comparison of different follow-up protocols].

Replacement of the proximal scaphoid pole with a silicone implant is a possible surgical treatment in cases of avascular necrosis of the proximal pole after scaphoid nonunion despite the possible development of silicone induced synovialitis. Based on six scores, the results of this procedure are discussed and scoring systems compared. After an average follow-up of 6.5 years, eleven patients with proximal scaphoid silicone implant were evaluated personally. The results were excellent in three patients, good in two and satisfactory in six patients. There were no poor results. In the six scores results were good or satisfactory. Mostly, satisfied patients with poor radiological results were seen. Number and weighting of the different criteria influence the results. We conclude that scaphoid silicone arthroplasty is an useful procedure for avascular necrosis of the proximal scaphoid pole. Patients may have a painless wrist and good range of motion for years. In some patients, silicone synovialitis is found. Before arthrodesis becomes inavoidable, some years of better mobility can be gained.