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KMID : 0361620100450030179
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Journal of the Korean Orthopaedic Association
2010 Volume.45 No. 3 p.179 ~ p.187
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A Comparative Study of Three Different Bone Grafting Methods for Treatment of Scaphoid Nonunion
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Cheon Sang-Jin
Cha Seung-Han
Kim Hui-Taek
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Abstract
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Purpose: Bone graft is a widely accepted surgical treatment for scaphoid nonunion. The purpose of this study was to analyze and compare the clinical outcomes of the three different bone graft techniques, Matti-Russe technique, Fisk-Fernandez technique and vascularized bone grafting.
Materials and Methods: This study involved 20 cases in 20 patients of established scaphoid nonunion who were treated with three different bone graft techniques and followed up for at least 1 year. We measured preoperative and postoperative pain, Mayo Modifi ed Wrist Score (MMWS) and range of motion of the affected and normal side. For radiological evaluation we assessed bone union, avascular necrosis, and dorsal intercalated segment instability (DISI).
Results: There were no signifi cant differences among the three groups with respect to the pain, MMWS, and range of motion. The union rate and correction of DISI also made no signifi cant difference. The time to achieve bone union, which averaged 2.6 months was signifi cantly decreased in the vascularized bone graft group than in the other two groups.
Conclusion: All three methods were proper surgical procedures for treatment of scaphoid nonunion because there was no statistically signifi cant difference in clinical and radiological outcomes. Among these three methods the vascularized bone grafting had the shortest time to achieve bone union so it could result in the fast functional recovery of the patient.
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KEYWORD
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scaphoid, nonunion, bone graft, matti-russe, fi sk-fernandez, vascularized bone graft
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