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Handchir Mikrochir Plast Chir 2020; 52(05): 413-418
DOI: 10.1055/a-1242-4415
Originalarbeit

Arthroscopic treatment for nonunion of the scaphoid

Arthroskopische Behandlung von Kahnbeinpseudarthrosen
Jan Ragnar Haugstvedt
1   Division of Hand Surgery, Department of Orthopedics, Østfold Hospital Trust, Peer Gynts vei 78, N-1535 Moss, Norway
,
Clara Wing-yee Wong
2   Department of Orthopedics & Traumatology, The Chinese University of Hong Kong, Sha Tin, Hong Kong
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Abstract

Scaphoid nonunion has traditionally been treated by open surgery where the pseudarthrosis has been cleaned while either a structural wedged bone graft, or chips of cancellous bone has been used to fill the defect. K-wires or a screw has been used to stabilize the bone. Using the arthroscopic technique for treatment of nonunion of the scaphoid gives us small exposure to the joint, however with an excellent view of the bones, the articular surfaces and the intraarticular ligaments. The results from arthroscopic treatment for scaphoid nonunion with bone grafting using chips of cancellous bone are as good as from the open technique. The arthroscopic treatment, though, helps us to diagnose and treat concomitant lesions. There is less damage of blood supply, nerves and capsule, which might lead to a faster recovery and rehabilitation. The technique will be described and discussed.

Zusammenfassung

Herkömmlicherweise werden Kahnbeinpseudarthrosen offen operiert, dabei die Pseudarthrose ausgeräumt, der resultierende Defekt entweder mit einem Knochenblock oder mit Spongiosachips aufgefüllt und das Kahnbein mit Schrauben oder Kirschnerdrähten stabilisiert. Bei der arthroskopischen Behandlung von Kahnbeinpseudarthrosen sind die Zugänge sehr klein, bieten aber trotzdem eine ausgezeichnete Sicht auf Knochen, Gelenkflächen und Bänder der Handwurzel. Die Ergebnisse der arthroskopischen Behandlung von Kahnbeinpseudarthrosen entsprechen denen des offenen Vorgehens. Vorteil der arthroskopischen Behandlung ist, dass gleichzeitig bestehende Bandverletzungen diagnostiziert und behandelt werden können, die Blutversorgung weniger beeinträchtigt wird und das Risiko einer Nervenverletzung und von Narbenadhäsionen geringer ist, was Genesung und Rehabilitation erleichtern mag. In dieser Arbeit wird die Technik der arthroskopischen Behandlung von Kahnbeinpseudarthrosen dargestellt und diskutiert.

Key words

Scaphoid nonunion - arthroscopy - arthroscopic treatment

Schlüsselwörter

Kahnbeinpseudarthrose - Arthroskopie - arthroskopische Behandlung


Publication History

Received: 30 July 2020

Accepted: 17 August 2020

Article published online:
29 September 2020

© Georg Thieme Verlag KG
Stuttgart · New York

 

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