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J Wrist Surg 2022; 11(06): 535-540
DOI: 10.1055/s-0041-1742097
Procedure

Arthroscopic Bone Graft and Internal Fixation of Non-Union of the Proximal Pole of the Scaphoid: Surgical Technique and Outcomes

Jeff Ecker
1   Jeff Ecker Clinic, Bethesda Hospital, Claremont, Western Australia, Australia
2   Hand and Upper Limb Centre, Claremont, Western Australia, Australia
,
Laiba Shahbaz
1   Jeff Ecker Clinic, Bethesda Hospital, Claremont, Western Australia, Australia
,
Sukhsimran Kohli
1   Jeff Ecker Clinic, Bethesda Hospital, Claremont, Western Australia, Australia
,
William Breidahl
3   Perth Radiological Clinic, Subiaco, Western Australia, Australia
,
Courtney Andrijich 
1   Jeff Ecker Clinic, Bethesda Hospital, Claremont, Western Australia, Australia
› Author Affiliations Funding None.
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Abstract

Background Fractures of the proximal pole of the scaphoid have been associated with delayed union, non-union, and avascular necrosis. This has been attributed to avascularity of the proximal pole of the scaphoid. While proximal pole non-unions can be successfully treated using open techniques, there is little information in the literature regarding arthroscopic bone graft and internal fixation of proximal pole non-unions.

Description of Technique After insertion of a 1.2-mm radiolunate K-wire, the scaphoid non-union was arthroscopically excised, bone grafted with iliac crest cancellous bone, and internally fixed with 3 × 1.2 mm K-wires.

Patients and Methods This is a retrospective study of patients who had arthroscopic bone graft of non-union of the proximal pole of the scaphoid between 2009 and 2021.

Results There were 30 cases in this study; 29 cases united. The one case that did not unite was caused by inadequate fixation of the proximal pole. The size of the proximal pole did not influence the outcome.

Conclusion Arthroscopic bone graft and internal fixation is a reliable technique for the treatment of non-union of the proximal pole of the scaphoid.

Keywords

scaphoid - proximal pole - arthroscopy - bone graft - non-union

Authors' Contributions

All the authors reviewed and edited the manuscript and approved the final version.


Ethical Approval

This study was approved by the St John of God Ethics Committee, number 1821.




Publication History

Received: 19 July 2021

Accepted: 17 November 2021

Article published online:
20 January 2022

© 2022. Thieme. All rights reserved.

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