Operative treatment of scaphoid nonunions

Abstract

43 reconstructive procedures were performed in nonunions and malunions of the scaphoid waist. In 8 cases of proximal pole nonunions the Chacha operation was carried out. Before surgical treatment SL angles and scaphoid length were measure on radiograms, taken with both hands in neutral position. Reconstruction procedures of the scaphoid waist were implemented basing on the carpal stretch test. Five different types of scaphoid nonunions were noted, basing on the localisation of the pathology. Operative procedures were selected in close correlation to nonunion localisation: simple reconstruction, reconstruction and revascularisation on the proximal part of the waist and rerevascularisation of the proximal pole. Additionally 3 revision procedures were performed in cases of nonunion after scaphoid reconstruction. Bone healing was observed in 49 cases, including the revision procedures.