Scaphoid fracture non-union: a systematic review of the arthroscopic management

Scaphoid fracture non-union: a systematic review of the arthroscopic management

Authors

  • Morena Anna Basso University of Naples "Federico II
  • Francesco Smeraglia University of Naples "Federico II"
  • Montserrat Ocampos-Hernandez Hospital Universitario Infanta Leonor, Madrid
  • Giovanni Balato University of Naples "Federico II"
  • Alessio Bernasconi University of Naples "Federico II"
  • Fernando Corella-Montoya Hospital Universitario Infanta Leonor, Madrid

Keywords:

Scaphoid, non-union, pseudoarthrosis, arthroscopy, bone graft

Abstract

Background and aim: There is no consensus regarding the most appropriate treatment of scaphoid nonunion. This systematic review aimed to investigate whether wrist arthroscopy exerts a positive influence on bone union and clinical outcomes.

Methods: We searched the literature on Medline (PubMed), Web of Science, Embase and Scopus databases using the combined keywords “scaphoid” AND “arthroscopy” AND “pseudoarthrosis” OR “nonunion”. Eighteen studies were finally included in our review. The quality of the studies was assessed using the Coleman Methodological Score.

Results: Our systematic review has shown that arthroscopic management of scaphoid nonunion achieves a high rate of union and satisfactory clinical outcomes with minimal complications.

Conclusions: There is need to perform randomized controlled trials reporting on the use of arthroscopy. In addition, the different pattern of pseudoarthrosis should be better classified to manage the patients who will benefit after the management.

References

Schiund F, Haentjens P, Van Innis F, Vander Meren C, Garcia Elias M, Sennwald G. Prognostic factors in the treatment of carpal scaphoid non-unions. J Hand Surg Am 1999 Jul;24(4):761-76. DOI: 10.1053/jhsu.1999.0761

Gelberman RH, Menon J. The vascularity of the scaphoid bone. J Hand Surg Am 1980 Sep;5:508–513. DOI: 10.1016/s0363-5023(80)80087-6

Pinder RM, Brkljac M, Rix L, Muir L, Brewster M. Treatment of Scaphoid Nonunion: A Systematic Review of the Existing Evidence. J Hand Surg Am 2015 Sep;40:1797-1805.e3. doi: 10.1016/j.jhsa.2015.05.003.

Wong WC, Ho PC. Arthroscopic Management of Scaphoid Nonunion. Hand Clin 2019 Aug;35:295-313. doi: 10.1016/j.hcl.2019.03.003.

Liberati A, Altman DJ, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta- analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ 2009 Jul 21;339: b2700. doi: 10.1136/bmj.b2700.

Coleman BD, Khan KM, Maffulli N et al. Studies of surgical outcome after patellar tendinopathy: clinical signifi- cance of methodological deficiencies and guidelines for future studies. Victorian Institute of Sport Tendon Study Group. Scan J Med Sci Sports 2000;10: 2–11. doi: 10.1034/j.1600-0838.2000.010001002.x.

Slade JF 3rd, Gillon T. Retrospective review of 234 scaphoid fractures and nonunions treated with arthroscopy for union and complications. Scand J Surg 2008;97:280-9. doi: 10.1177/145749690809700402.

Slade JF 3rd, Geissler WB, Gutow AP, Merrell GA. Percutaneous internal fixation of selected scaphoid nonunions with an arthroscopically assisted dorsal approach. J Bone Joint Surg Am 2003;85-A Suppl 4:20-32. doi: 10.2106/00004623-200300004-00003.

Ecker J, Shahbaz L, Kohli S, Breidhal W, Andrijich C. Arthroscopic bone graft and internal fixation of non-union of the proximal pole of the scaphoid: surgical technique and outcomes. J Wrist Surg 2022 Jan 20; 04:279-374. DOI: 10.1055/s-012-54202

Cognet JM, Louis P, Martinache X, Schernberg F. Arthroscopic grafting of scaphoid nonunion - surgical technique and preliminary findings from 23 cases. Hand Surg Rehabil 2017 Feb;36:17-23. doi: 10.1016/j.hansur.2016.11.002

Chu PJ, Shih JT. Arthroscopically assisted use of injectable bone graft substitutes for management of scaphoid nonunions. Arthroscopy 2011 Jan;27:31-7. doi: 10.1016/j.arthro.2010.05.015.

Kim JP, Seo JB, Yoo JY, Lee JY. Arthroscopic management of chronic unstable scaphoid nonunions: effects on restoration of carpal alignment and recovery of wrist function. Arthroscopy 2015 Mar;31:460-9. doi: 10.1016/j.arthro.2014.08.035.

Kang HJ, Chun YM, Koh IH, Park JH, Choi YR. Is Arthroscopic Bone Graft and Fixation for Scaphoid Nonunions Effective? Clin Orthop Relat Res 2016 Jan;474:204-12. doi: 10.1007/s11999-015-4495-3

Oh WT, Kang HJ, Chun YM, Koh IH, Lee YJ, Choi YR. Retrospective Comparative Outcomes Analysis of Arthroscopic Versus Open Bone Graft and Fixation for Unstable Scaphoid Nonunions. Arthroscopy 2018 Oct;34:2810-2818. doi: 10.1016/j.arthro.2018.04.024.

Gvozdenovic R, Joergensen RW, Joerring S, Jensen CH. Arthroscopically Assisted Bone Grafting Reduces Union Time of Scaphoid Nonunions Compared to Percutaneous Screw Fixation Alone. J Wrist Surg 2020 Feb;9:13-18. doi: 10.1055/s-0039-1693146.

Cifras JL, Azocar C, Sanhueza M, Cavalla P, Liendo R. Arthroscopic treatment for scaphoid pseudoarthrosis with humpback: surgical technique and case series. Rev Chil Orthop Traumatol 2019;60:47-57. doi: 10.1055/s-0039-1698416

Waitayawinyu T, Lertcheewanan W, Boonyasirikool C, Niempoog S. Arthroscopic Treatment of Scaphoid Nonunion With Olecranon Bone Graft and Screw Fixation Leads to Union and Improved Outcomes. Arthroscopy 2022 Mar;38:761-772. doi: 10.1016/j.arthro.2021.09.018.

Kang HJ, Chun YM, Oh WT, Koh IH, Lee SY, Choi YR. The Effect of Debridement of Coexisting Partial Ligament Injuries on Outcomes Following Arthroscopic Osteosynthesis for Minimally Displaced Scaphoid Nonunions. J Hand Surg Am 2016 Jun;41:e135-42. doi: 10.1016/j.jhsa.2016.04.007.

Delgado-Serrano PJ, Jiménez-Jiménez I, Nikolaev M, Figueredo-Ojeda FA, Rozas-López MG. Arthroscopic reconstruction for unstable scaphoid non-union. Rev Esp Cir Ortop Traumatol 2017 Jul-Aug;61:216-223. doi: 10.1016/j.recot.2017.03.002.

Liu B, Wu F, Ng CY. Wrist arthroscopy for the treatment of scaphoid delayed or nonunions and judging the need for bone grafting. J Hand Surg Eur 2019 Jul;44:594-599. doi: 10.1177/1753193419841253.

Wang JP, Huang HK, Shih JT. Arthroscopic-assisted reduction, bone grafting and screw fixation across the scapholunate joint for proximal pole scaphoid nonunion. BMC Musculoskelet Disord 2020 Dec 10;21:834. doi: 10.1186/s12891-020-03850-w.

Slade JF, Dodds SD. Minimally invasive management of scaphoid nonunions. Clin Orthop Relat Res 2006 Apr;445:108-119. doi: 10.1097/01.blo.0000205886.66081.9d.

Lee YK, Choi KW, Woo SH, Ho PC, Lee M. The clinical result of arthroscopic bone grafting and percutaneous K-wires fixation for management of scaphoid nonunions. Medicine (Baltimore) 2018 Mar;97:e9987. doi: 10.1097/MD.0000000000009987.

Lamon B, Ardouin L, Bellemère P, Dautel G, Athlani L. Arthroscopic Bone Grafting for Scaphoid Nonunion: A Retrospective Study of 42 Cases. J Hand Surg Asian Pac Vol 2021 Dec;26:545-554. doi: 10.1142/S242483552150051X.

Schernberg F. Fractures récentes du scaphoïde (moins de trois semaines) [Recent scaphoid fractures (within the first three weeks)]. Chir Main 2005 Jun- Aug;24(3-4):117-31. doi: 10.1016/j.main.2005.05.001.

Hsiung W, Huang HK, Wang JP, Chang MC, Huang YC. Arthroscopic realignment and osteosynthesis of unstable scaphoid nonunion with cancellous bone graft from the ipsilateral radius. Int Orthop 2021 Jan;45:191-197. doi: 10.1007/s00264-020-04840-2.

Augat P, Margevicius K, Simon J, Wolf S, Suger G, Claes L. Local tissues properties in bone healing: influence of size and stability of the osteotomy gap. J Orthop Res 1998 Jul;16:475-481. doi: 10.1002/jor.1100160413.

Mathoulin CL, Arianni M. Treatment of the scaphoid humpback deformity – is correction of the dorsal intercalated segment instability deformity critical? J Hand Surg Eur 2018 Jan;43:13-23. doi: 10.1177/1753193417739526.

Amadio PC, Berquist TH, Smith DK, Ilstrup DM, Cooney WP3rd, Linsheid RL. Scaphoid malunion. J Hand Surg Am 1989 Jul;14:679-87. doi: 10.1016/0363-5023(89)90191-3.

Nakamura R, Imaeda T, Miura Y. Scaphoid non malunion. J Bone Joint Surg Br 1991;73:134-7. doi: 10.1302/0301-620X.73B1.1991749.

Fernandez DL, Martin CJ, Gonzalez-Del Pino J. Scaphoid malunion: the significate of rotational malalignment. J Hand Surg Br 1998 Dec;23:771-5. doi: 10.1016/s0266-7681(98)80094-6.

Sayegh ET, Strauch RJ. Graft choice in the management of unstable scaphoid nonunion: a systematic review. J Hand Surg Am 2014 Aug;39:1500-6. doi: 10.1016/j.jhsa.2014.05.009.

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Published

17-10-2023

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Section

ORTHOPAEDICS AND SURGERY

How to Cite

1.
Scaphoid fracture non-union: a systematic review of the arthroscopic management. Acta Biomed [Internet]. 2023 Oct. 17 [cited 2024 Jun. 17];94(5):e2023194. Available from: https://mattioli1885journals.com/index.php/actabiomedica/article/view/14646

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