[The results of autologous bone graft and titanium headless cannulated compression screw for treatment of scaphoid nonunion].

BACKGROUND

We aimed to present the clinical and radiological results of patients treated with debridement, iliac bone graft and titanium headless compression screw for scaphoid nonunion.

METHODS

We retrospectively evaluated 24 patients (23 males, 1 female) who underwent this technique between 2009 and 2012, with a minimum of 12 months' follow-up. Nonunion was determined as no union evidence within eight weeks on radiological view. Scaphoid fracture was classified according to Herbert classification and anatomical location. Functional evaluation was performed using the Mayo wrist scoring system.

RESULTS

According to the Herbert classification system, there were 20 D1 and 4 D2 fractures. Anatomical location included 1 distal, 6 proximal and 17 corpus. Fracture union was achieved in all but 2 patients, with a mean union time of 9.5 weeks (6-15). Scapholunate angle and radiolunate angle were measured as a mean 32° (39°-50°) and 7° (4°-10°) at the latest follow-up radiographic examination. There was a statistically significant correlation between the length of the pseudoarthrosis period and union time (p=0.003). Union time of proximal fractures was longer than of the others (p=0.004). Mayo wrist score was 86 (80-95).

DISCUSSION: Autologous iliac bone graft and titanium headless cannulated compression screw combination via volar approach is safe and effective for scaphoid nonunion.