Results of surgical treatment of carpal scaphoid pseudoarthrosis using the Fisk-Fernández technique

Abstract

AimThe aim of the study was to evaluate the clinical and radiological results obtained in the treatment of carpal scaphoid non-union treated at the University Hospital of Valladolid using the Fisk-Fernández technique. Materials and methodsA review was performed on 43 cases of surgically treated non-union using Fisk-Fernández technique with a minimum of 6 months follow-up. The time until surgery, previous treatment, the mechanism of injury, type of non-union, and the existence of radio-carpal arthrosis were evaluated.A subjective evaluation was performed using the “Scaphoid Score” and the DASH, plus an objective assessment with the modified Green & O’Brien, together with the measurement of the intra-scaphoid, radioulnar, scapholunate angles, and carpal height. ResultsThe median time to healing in the series was between 16 and 24 weeks, except in 3 patients who failed to heal and required salvage surgery.There was a statistically significant variation between the preoperative and postoperative angles and carpal height measured in the X-rays. DiscussionThere are different osteosynthesis techniques and materials for the treatment of non-union. The evaluation of results performed using objective and subjective scales showed variable results between studies.Different techniques are aimed at preventing the progression of the disease. ConclusionThe Fisk-Fernández technique enables the deformity of the scaphoid to be corrected by wedge grafting and internal fixation with Kirschner wires or screws.