Acta chirurgiae orthopaedicae
et traumatologiae Čechoslovaca

Acta Chir Orthop Traumatol Cech. 2023; 90(6):422-426 | DOI: 10.55095/achot2023/051

Is Bone Grafting Unnecessary in the Treatment of Cystic Scaphoid Pseudoarthrosis?Original papers

E. C. ZENGİN¹, H. ERTEM² MD, S. SARUHAN³, T. ÖZTÜRK¹, M. SENER⁴

¹ Department of Orthopaedics and Traumatology, Tokat Gaziosmanpaşa University, Tokat, Turkey

² Department of Orthopaedics and Traumatology, Mus State Hospital, Mus, Turkey

³ Department of Orthopaedics and Traumatology, Bozyaka Training and Research Hospital, İzmir, Turkey

⁴ Private Clinic, İzmir, Turkey

Purpose of the study: The basic aim of the treatment of cystic nonunion is to provide stable fixation and mechanical compression to increase union, but there is no consensus on whether to perform bone grafting in the cystic area or not. The aim of this study was to compare the clinical and radiological results of patients with cystic scaphoid non-union who received open grafting, and internal fixation and those treated with percutaneous fixation without grafting.

Material and Methods: A retrospective evaluation was made of patients included those determined radiologically with Slade and Dodds grade IV scaphoid cystic non-union. Two different surgical procedures were performed. Percutaneous screw fixation was carried out on the patients in group 1. Open curettage-grafting and screw fixation were performed on the patients in group 2. Group 1 was comprised of 16 patients treated with percutaneous screw fixation, and group 2 was comprised of 17 patients who had open curettage-grafting and screw fixation.

Results: In the radiological evaluation at the final follow-up examination, union was determined in 12 of the 16 (75%) patients in group 1 and 15 of the 17 (88%) patients in group 2. There was no statistically significant difference between the two groups in terms of union, functional outcomes and complication rates.

Discussion: In the current study, the union rate was higher in the patients who had open curettage-grafting and fixation with a headless screw (88%) than in those with percutaneous screw without grafting (75%), but the difference was not determined to be statistically significant. The union rate of the group that received grafting was similar to the rates reported in the literature.

Conclusions: We think that both of these techniques may be successfully used for cystic scaphoid nonunions but percutaneous technique should be preferred as it is minimally invasive. Nevertheless, there is a need for further prospective, randomised studies with larger series to have better comparisons.

Keywords: cstyle

Published: December 1, 2023  Show citation