Abstract
Objective To describe the clinical and radiographic outcomes of patients submitted to percutaneous
fixation without bone graft for scaphoid nonunion, with a minimum follow-up of six
months.
Methods A case series study of a convenience sample of hand surgeons with prospective evaluation.
Patients with scaphoid (waist or proximal pole) nonunion and the following features
were included: more than six months of history; X-rays showing sclerosis of the edges
of the nonunion, with resorption of the nonunion focus measuring less than 4 mm (Slade
& Gleissler I, II, III and IV) and no angular deformity; and no proximal pole necrosis
on magnetic resonance imaging (MRI).
Results After six months of follow-up, all nonunion were consolidated, with no major complications.
The functional outcomes revealed good scores on the disabilities of the arm, shoulder
and hand (DASH; n = 12; mean: 6.9; standard deviation [SD]: 2.1) and patient-rated
wrist evaluation (PRWE; n = 12; mean: 7.97, SD: 1.5) questionnaires. The results of
the visual analog scale (VAS) showed little residual pain (n = 12; mean: 0.71; SD:
0.2). Slight decreases in flexion (69 versus 59.1; p = 0.007), extension (62.4 versus 48.7; p = 0.001) and radial deviation (29.6 versus 24.6; p = 0.014) were detected in comparison to the contralateral side.
Conclusions All cases in the series presented consolidation and good functional scores at the
six-month evaluation. This is a promising option (with lower technical demand and
morbidity) for the treatment of scaphoid nonunion. Comparative studies are required
to assess the effectiveness of this technique in comparison with other options.
Keywords
fractures, bone - scaphoid bone - pseudarthrosis
