Scaphoid Fractures and Nonunions: Recent Trends of Treatment

Park,  Jong Woong

Review

Journal of the Korean Society for Surgery of the Hand 2011;16(2):116-126.
Published online June 30, 2011.

Scaphoid Fractures and Nonunions: Recent Trends of Treatment

Jong Woong Park

Department of Orthopedic Surgery, Korea University College of Medicine, Seoul, Korea. ospark@korea.ac.kr

Received: 25 April 2011 • Accepted: 15 May 2011

Abstract

Scaphoid fracture is a common carpal bone fracture. Through the accurate diagnosis and proper treatment, the union can be easily achieved without significant complication. Although the non-operative treatment is successful to get union in the limited cases of undisplaced or occult fracture, the percutaneous screw fixation is better treatment option for the young and active patient. Rigid percutaneous screw fixation heals the fracture faster and the patient can return to their usual life earlier. In the nonunion cases of scaphoid fracture, open reduction and internal fixation and conventional bone graft generally heals the nonunion. In the case of failed bone graft or avascular necrosis of the proximal fragment, a pedicled vascularized bone graft is a good strategy for the union. If severe humpback deformity or shortening is combined with the avascular necrosis of proximal fragment, a free vascularized medial femoral condyle bone graft is indicated as a last treatment option for successful union.