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J Wrist Surg 2020; 09(04): 304-311
DOI: 10.1055/s-0040-1710383
Scientific Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Postoperative Outcomes of Volar Plate Fixation in Cases of Scaphoid Deformity or Nonunion: A Case Series

Saif A. Ansari
1   School of Medicine, University of Central Lancashire, Lancashire, United Kingdom
,
James A. Kennedy
2   Department of Trauma and Orthopaedics, Health Education North West ST6 Trauma and Orthopaedics, Health Education North West, Lancashire, United Kingdom
,
Fizan Younis
1   School of Medicine, University of Central Lancashire, Lancashire, United Kingdom
3   Department of Hand Surgery, University of Central Lancashire, East Lancashire Hospitals National Health Service Trust, Lancashire, United Kingdom
› Author Affiliations Funding None.
Further Information

Publication History

07 February 2020

24 March 2020

Publication Date:
20 May 2020 (online)

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Abstract

Background Fractures through the waist of scaphoid are a common injury, resulting in deformity or nonunion. Recently, a locking plate has been shown to fix deformity or nonunion of scaphoid, with limited observation of functional postoperative outcomes.

Objectives We present a case series of 16 patients, with the disabilities of the arm, shoulder, and hand (DASH) score evaluation in primary fixation of scaphoid fractures with humpback deformity (n = 11) and revision open reduction internal fixation (ORIF) for nonunion (n = 5), using the Medartis TriLock 1.5 scaphoid plate and bone grafting.

Patients and Methods DASH scores were obtained preoperatively and postoperatively at 3, 6, and 12 (if required) months. Patient demographics, smoking status, employment type, and grip strengths were recorded.

Results Thirteen patients attended follow-up. Union was clinically and radiologically assessed with 13 achieving union. The mean preoperative DASH score was 34.0 (n = 16) and at treatment completion (discharge or DNA) was 11.5 (n = 13), with mean reduction of 18.5 (p = 0.03). At treatment completion, mean reduction in DASH score of revision ORIF was 13.7 (p = 0.27; n = 4), compared with 20.7 (p < 0.01; n = 9) in primary fixation with plate.

Conclusions Deformity correction, reduction in DASH score, and rate of union make the plate system useful in the management of scaphoid fractures with humpback deformity and revision for nonunion.

Level of Evidence This is a Level IV study.

Keywords

scaphoid fracture - humpback deformity - nonunion - plate fixation - DASH score

Ethical Approval

East Lancashire Hospitals National Health Service Trust does not require ethical approval for reporting individual cases or case series.


Authors' contributions

F. Y. conceived the study, populated patient data and directed the study. J. K. and S. A. A. researched literature and performed data analysis. S. A. A. and J. K. wrote the first draft of the manuscript. All authors reviewed and edited the manuscript and approved the final version of the manuscript.


 

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