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KMID : 0922220080080020114
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Journal of the Korean Musculoskeletal Transplantation Society
2008 Volume.8 No. 2 p.114 ~ p.121
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Treatment of Scaphoid Nonunion Using Autogenous Iliac Corticocancellous Bone Graft
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KIm Jong-Min
Jeon Seung-Ju
Moon Chan-Sam
Noh Haeng-Kee
Jung Hyung-Jun
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Abstract
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Purpose: To evaluate the results of autogenous iliac corticocancellous bone graft in scaphoid nonunion.
Materials and Methods: Nine cases of scaphoid waist nonunion without avascular necrosis of proximal fragment were included in this study which were treated with autogenous iliac corticocancellous bone graft and should be followed up more than 1 year. The fixation was done with multiple K-wire due to lack of reliability with screw fixation. Radiologically bony union was evaluated with assessing the bony trabecular continuity and dorsal angular deformity was evaluated with measuring the intrascaphoid angle in sagittal radiographs. The clinical outcomes were evaluated with Mayo modified wrist score assessing pain, range of motion, grip strength and activities.
Results: We obtained radiologically bony union in 9 cases of scaphoid waist nonunion and the intrascaphoid angle on sagittal radiographs was measured not more than 35 degrees. Mayo modified wrist score was increased from preoperatively 58 to postoperatively 91 and excellent score was recorded in 4 cases (44%) and good in 5 (56%).
Conclusion: We think that autogenous iliac corticocancellous bone graft is a good method of osteosynthesis in scaphoid waist nonunion without avascular necrosis and K-wire fixation is one of the alternative method when the reliable rigid fixation will not be obtained with screw fixation.
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KEYWORD
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Scaphoid, Nonunion, Autogenous iliac corticocancellous bone graft, K-wire
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