Clinical outcome of scaphoid malunion as a result of scaphoid fracture nonunionsurgical treatment: A 5-year minimum follow-up study

摘要

Background. - Although malunion resulting from reconstruction for scaphoid fracture nonunion is atypical complication, there has been little consideration regarding its clinical outcomes.Hypothesis. - The quality of restoration of the scaphoid anatomy may have little effect on clinical out-comes. Materials and methods. - Twenty-five patients with scaphoid fracture nonunion underwent curettageand internal fixation with bone grafting performed by a single surgeon, and they were followed up for aminimum of 5 years. Some of these patients comprised the malunion group if the height/length ratio (H/Lratio) in the most central longitudinal computed tomographic image was more than 0.6. We comparedthe clinical outcomes of the malunion group with a well-union group based on various clinical scores(patient evaluation measure, disabilities of the arm, shoulder and hand, modified Mayo wrist scoringsystem). Results. - The average follow-up period was 81 (range, 65-110) months, and 15 cases among the 25patients were included in the malunion group. There were no statistical differences in the clinical scoresbetween malunions (15 cases) and well unions (10 cases), and there was no correlation between the H/Lratios and the clinical outcomes. Conclusion. - The clinical outcomes of malunited scaphoids after reconstruction for scaphoid fracturesnonunion did not differ significantly from well-united scaphoids at a minimum 5-year follow-up.Level of evidence. - Level IV, prognostic case series.