Early Clinical Results of Arthroscopic Bone Grafting and Percutaneous K-Wire Fixation for the Treatment of Scaphoid Non-Union

Abstract

Objectives: The aim of this study was to examine the clinical results of patients treated with arthroscopic autologous bone grafting and K-wire fixation in surgery for scaphoid non-union, and the factors affecting the success of this method. Materials and Methods: This single-centre retrospective study included 9 patients (7 males, 2 females) with a mean age of 31 years (range, 20-45 years). Radiological evaluations of the patients were made from direct radiographs and computed tomography images. The disability of the arm shoulder and hand (DASH), Mayo wrist score (MWS), and visual analog scale (VAS) scores were used in the evaluation of functional results. The range of flexion -extension of the wrist was evaluated pre and postoperatively. Grip strength of the operated hand was measured postoperatively and was compared with the non-operated contralateral hand. Results: The mean time to union of the scaphoid bone was 8.5 weeks. Non-union was observed in 3 patients. The VAS score of the patients decreased from 6.5 preoperatvely to 1.7 postoperatively, and the wrist range of movement increased from 81° to 101°. These values were determined to be 75% of those of the non-operated side. The DASH score and MWS improved postoperatively. Conclusion: The main reasons for failure are not observing bleeding points in the fracture ends with debridement of the non-union area and early removal at the end of 8 weeks of the fixation made with K-wires in a second operation. The use of headless screws instead of K-wires in this technique can reduce the rates of surgical failure.