Die Skaphoidpseudarthrose: Kritische Analyse der derzeitigen Wiederherstellungsverfahren

Abstract

INTRODUCTION: Currently performed surgical procedures for scaphoid nonunion were evaluated on the basis of a retrospective study of two different treatment groups. METHOD: 55 patients with scaphoid nonunion were evaluated clinically and radiologically on average 10.7 years after the Matti-Russe procedure. The Matti-Russe group was compared to a group of 43 patients with scaphoid nonunion who received bone grafting and Herbert screw fixation with an average follow up of 11.0 years RESULTS: 69% of all patients of the Matti-Russe group developed mostly advanced osteoarthritis of the carpus. In 38% a malunion of the scaphoid was and in 18% a DISI-deformity was found. The majority of patients after Matti-Russe procedure experienced limitations concerning the range of motion. At time of follow up, only 21% of the patients treated with the Herbert screw suffered from an osteoarthritis of the carpus, mainly in an initial stadium. A scaphoid malunion was found in 7% and a DISI-deformity in 5% of the patients. A minority of the Herbert screw group presented a decreased range of motion at follow up. DISCUSSION: Internal fixation and bone grafting is currently the gold standard in the surgical treatment of scaphoid nonunions. The correct reconstruction of the scaphoid shape is crucial for the outcomes.