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CC BY 4.0 · Rev Bras Ortop (Sao Paulo) 2024; 59(05): e719-e729
DOI: 10.1055/s-0043-1770969
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Arthroscopy Treatment of Scaphoid Pseudarthrosis: Description of the Technique and Case Series

Article in several languages: português | English
Ricardo Kaempf
1   Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brasil
,
João Brunelli 
1   Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brasil
,
Leohnard Bayer
1   Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brasil
,
Márcio Aita
2   Faculdade de Medicina do ABC, Santo André, SP, Brasil
,
Santhiago Pereira Schneider
1   Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brasil
,
Pedro J. Delgado
3   Hospital Universitário Madrid Montepríncipe, Universidad CEU San Pablo, Boadilla del Monte, Madri, Espanha
› Author Affiliations Financial Support The authors declare that they received no financial support from public, commercial or non-profit sources.
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Abstract

Objective To describe the procedure and evaluate the results of a series of patients with stable and unstable pseudarthrosis of the scaphoids treated with the use of arthroscopy associated with cancellous bone graft and compression screw.

Methods Twenty-three patients were treated with this technique. The minimum postoperative follow-up was 12 months, and pre- and postoperative functional, clinical, and imaging analyses were performed.

Results Themean time from fracture to surgery was 26 months (12–60). Preoperative and postoperative clinical and radiological parameters were analyzed. The mean follow-up was 24.2 (12–60) months. Consolidation occurred in 22 patients (95.6%) in an average of 7.5 (4–12) weeks. Mean flexion range ofmotion improved from73.6° (60–80°) to 79.5° (60–90°); the range from 68.6° (50–80°) to 71.9° (45–85°); ulnar deviation from 20.6° (15–30°) to 26.9° (20–35°); and the radial deviation from 17.3° (15–25°) to 20.4° (10–25°). Pain (Visual Analog Scale [VAS] 0–10) improved from 7.3 (4–9) to 0.7 (0–6) and DASH functional scale improved from 49 (32–75) to 6 (2–12). The scapholunate angle improved from 69.1° (55–85°) to 48.4° (40–55°) and the radiolunar angle improved from 30° (10–40°) to 2.6° (0–8°).

Conclusion Treatment of stable and unstable pseudarthrosis of the scaphoid with spongy bone graft and percutaneous internal fixation, preferably with a headless compression screw, assisted by arthroscopy, showed good clinical and radiographic results in our series, with a short time for consolidation and functional recovery.

Keywords

arthroscopy - bone screws - graft - pseudarthrosis - scaphoid bone - wrist

Work carried out at the Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil.




Publication History

Received: 09 March 2022

Accepted: 16 December 2022

Article published online:
29 January 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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