Treatment of scaphoid nonunions by Russe bone grafting--a retrospective analysis.

Forty-five patients with symptomatic established delayed union and nonunion of the scaphoid were operated between January 1983 and December 1997. The Russe anterior corticocancellous bone-grafting was performed in twenty-five cases. Using a grading system, we analyzed the suitability of this method, for three types of nonunion. We attained a 92% bony union rate of all nonunions grafted. Review of the relevant literature shows that there was same significant difference in union rates between the types of nonunion, the vascularity of the proximal fragment and the presence of dorsal intercalated segment instability (DISI). The aims of this procedure are to obtain a good functional wrist without pain and to prevent late arthritis.