Mid-term results of a minimally invasive management of scaphoid non-union: Arthroscopy-assisted osteosynthesis and autologous bone grafting.

OBJECTIVE

To analyze clinical and radiological mid-term outcomes in patients with scaphoid pseudarthrosis treated with arthroscopy-assisted osteosynthesis and autologous bone grafting.

MATERIALS AND

METHODS

Thirty-one patients (27 males, 4 female) were included in a retrospective study, with one bilateral case. The mean age was 28 years, and mean follow-up was 54 months. Twenty-six non-unions were in the waist, 5 in the proximal third, and one in the distal third. Arthroscopic debridement was performed and autologous bone graft from iliac crest was used. Fixation was performed percutaneously with a compression screw. Clinical and radiological evaluations were conducted preoperatively and postoperatively at one, three, six and twelve months. An additional mid-term follow-up visit was conducted. Patients were assessed for pain, wrist strength, range of motion and functional outcomes.

RESULTS

Radiological consolidation was achieved in 100% of cases within 12 weeks, with a mean of 10 weeks. Pain on the visual analog scale decreased from 7.1 to 1.5. Wrist strength improved from 27 to 48kg. Quick DASH improved from 58 to 11. Range of motion also increased: flexion from 51° to 71°, extension from 47° to 73°, radial deviation from 12° to 15°, and ulnar deviation from 23° to 36°. No complications were observed among the studied patients, and all returned to their respective jobs.

CONCLUSIONS

Arthroscopy-assisted osteosynthesis with percutaneous compression screw and cancellous bone grafting has proven to be a viable method for the treatment of scaphoid pseudarthrosis, with low morbidity, good functional mid-term outcomes, and short consolidation periods.