Young-Keun Lee1, Ki-Bum Kim. 1. Department of Orthopedic surgery, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonbuk National University Medical School Jeonju, Jeonbuk, 54907 - 54896, Republic of Korea.
Abstract
RATIONALE: The treatment methods of pediatric scaphoid nonunion are still controversial. To our knowledge, arthroscopic-assisted treatments for pediatric scaphoid nonunion has not been reported in the English-language literature. Therefore, the purpose of this study is to report the use of arthroscopic-assisted bone grafting for scaphoid nonunion fracture in 3 patients and present a literature review. PATIENTS CONCERNS: Two 15-year-old patients developed carpal joint injuries over a year, prior to their hospital presentation, since they had not received adequate treatment. The third patient, 12 years of age, was diagnosed with scaphoid fracture after a traffic accident and underwent conservative treatment but presented to the hospital due to issues related with bone union. DIAGNOSIS: All 3 patients were diagnosed with scaphoid nonunion at our hospital, using plain wrist radiographs and computed tomography. INTERVENTIONS: All the patients underwent arthroscopic debridement; 2 patients received autogenous iliac cancellous bone graft, while the other patient received a bone substitute graft. The internal fixation of the scaphoid was performed with K-wires. OUTCOMES: Bone unions were achieved in all patients, and the final follow-up resulted in successful outcomes. LESSONS: Arthroscopic-assisted bone grafting and percutaneous K-wire fixation can be considered as a good method for the treatment of pediatric scaphoid nonunion fractures. Therefore, it is a primary treatment option for symptomatic scaphoid nonunion fracture and displaced fractures.
RATIONALE: The treatment methods of pediatric scaphoid nonunion are still controversial. To our knowledge, arthroscopic-assisted treatments for pediatric scaphoid nonunion has not been reported in the English-language literature. Therefore, the purpose of this study is to report the use of arthroscopic-assisted bone grafting for scaphoid nonunion fracture in 3 patients and present a literature review. PATIENTS CONCERNS: Two 15-year-old patients developed carpal joint injuries over a year, prior to their hospital presentation, since they had not received adequate treatment. The third patient, 12 years of age, was diagnosed with scaphoid fracture after a traffic accident and underwent conservative treatment but presented to the hospital due to issues related with bone union. DIAGNOSIS: All 3 patients were diagnosed with scaphoid nonunion at our hospital, using plain wrist radiographs and computed tomography. INTERVENTIONS: All the patients underwent arthroscopic debridement; 2 patients received autogenous iliac cancellous bone graft, while the other patient received a bone substitute graft. The internal fixation of the scaphoid was performed with K-wires. OUTCOMES: Bone unions were achieved in all patients, and the final follow-up resulted in successful outcomes. LESSONS: Arthroscopic-assisted bone grafting and percutaneous K-wire fixation can be considered as a good method for the treatment of pediatric scaphoid nonunion fractures. Therefore, it is a primary treatment option for symptomatic scaphoid nonunion fracture and displaced fractures.
Authors: George D Chloros; George S Themistocleous; Ethan R Wiesler; Ioannis S Benetos; Dimitrios G Efstathopoulos; Panayotis N Soucacos Journal: J Hand Surg Am Date: 2007-02 Impact factor: 2.230
Authors: Felix Angst; Susann Drerup; Stephan Werle; Daniel B Herren; Beat R Simmen; Jörg Goldhahn Journal: BMC Musculoskelet Disord Date: 2010-05-19 Impact factor: 2.362