Abstract
The objective of this article is to report our clinical experience in the treatment of patients with scaphoid nonunion using intercalated bone graft and Herbert’s screw and the long-term postoperative results with a minimum of five years of follow-up. We retrospectively reviewed 49 patients treated with carved intercalated bone graft and Herbert’s screw fixation from September 1987 to June 2001. Preoperative clinical manifestations and postoperative results were assessed by radiography, and functional results, including grip force, range of motion of the wrist joint, and Cooney’s scoring chart, were evaluated. The union rate was 93.9%. The average grip power, as well as wrist flexion and extension were significantly improved. Using Cooney’s scoring system, 29 patients were rated excellent and 17 good. For successful union, anatomical reduction with carved intercalated bone grafting and Herbert’s screw fixation is definitely a reliable option. This method leads to a satisfactory long-term functional outcome.
Résumé
L’objectif de cette étude est de rapporter le résultat clinique du traitement des pseudarthroses du scaphoïde traitées par greffe intercalaire et vis de Herbert. Les résultats ont été évalués à long terme avec un minimum de recul à 5 ans. Matériel et méthode: il s’agit d’une étude rétrospective de 49 patients traités selon cette technique de septembre 1987 à juin 2001. L’évaluation pré et post-opératoire a porté sur les signes cliniques, la radiographie, les signes fonctionnels en incluant la force de préhension et la mobilité du poignet ainsi que le score de Cooney. Résultats: le taux de consolidation a été de 93,9%. La force de préhension et la mobilité du poignet en flexion et en extension ont été améliorées de façon significative. Le score de Cooney était côté sur 29 patients excellents et bons chez 17 patients. Conclusion: Cette technique est une technique parfaitement fiable du traitement des pseudarthroses et permet d’obtenir des résultats satisfaisants à long terme tant sur le plan fonctionnel que sur le plan anatomique.
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Huang, YC., Liu, Y. & Chen, TH. Long-term results of scaphoid nonunion treated by intercalated bone grafting and Herbert’s screw fixation—a study of 49 patients for at least five years. International Orthopaedics (SICOT) 33, 1295–1300 (2009). https://doi.org/10.1007/s00264-008-0663-3
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DOI: https://doi.org/10.1007/s00264-008-0663-3