Treatment of old scaphoid fracture by radial approach of wrist

Abstract

Objective To evaluate the clinical efficacy of the radial styloid process excision combined with bone grafting and internal fixation through radial approach of wrist in the treatment of old scaphoid fracture. Methods From January 2003 to September 2016, 62 cases of old scaphoid fracture nonunion were treated by the radial styloid process excision combined with bone grafting and internal fixation through radial approach of wrist. The wrist joint was immobilized with a plaster cast postoperatively. X-ray examination was performed 3 months after the operation. If the fracture was not healed, the plaster or brace should be used to continue to fix it until the fracture line was blurred, and the recovery of wrist function should be observed. Results All the patients were follow-up for 6 to 24 months with an average of 18 months. Bone healing was achieved in all the patients, with an average healing time of 6 months. The wrist function was evaluated according to the modified Mayo Wrist Function Score. The results were rated as excellent in 40 cases, good in 15 cases and fair in 7 cases, with the excellent and good rate being 88.7%. Conclusion It is simple and effective to treat old scaphoid fracture with the radial styloid process excision combined with bone grafting and internal fixation through radial approach of wrist. The surgical trauma is small. Bone grafting and fixation can be completed in the same incision. Key words: Scaphoid bone; Treatment outcome; Old fracture; Surgical approach