Risk Factors of Nonunion after Surgical Fixation of Acute Scaphoid Fractures

Lee,  Sang Myung; Park,  Sang Won; Park,  Bum Young; Song,  Seok Whan; Lee,  Yoon Min; Rhee,  Seung Koo

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Journal of the Korean Society for Surgery of the Hand 2011;16(1):23-28.
Published online March 1, 2011.

Risk Factors of Nonunion after Surgical Fixation of Acute Scaphoid Fractures

Sang Myung Lee, Sang Won Park, Bum Young Park, Seok Whan Song, Yoon Min Lee, Seung Koo Rhee

Department of Orthopedic Surgery, Yeouido St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea. skrhee@catholic.ac.kr

Abstract

Purpose
The aim of this study was to assess the risk factors of nonunion after surgical treatment of acute scaphoid fractures. MATERIALS AND METHODS: Predictable risk factors were investigated retrospectively in 70 patients with an acute scaphoid fracture. The risk factors involved sex, age, profession, smoking, fracture location, fracture gap distance, type of lunate, ulnar variance, fixation method, and surgical approach. At twelve months after surgery, analysis was conducted to identify the factors for prognosis toward bone healing or failure.

Results
Sixty-four patients (91%) demonstrated radiological union after a mean time of 2.8 months. The average scapholunate angle was 52degrees at the final follow up. Professional heavy work, smoking, fracture of proximal pole were associated with a significantly decreased likelihood of healing.

Conclusion
The patients who have the risk factors of nonunion such as heave work, smoking and fracture of proximal pole should be treated carefully.

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