Osteosynthesis and Trauma Care 2005; 13(4): 203-207
DOI: 10.1055/s-2005-836628
Original Article

© Georg Thieme Verlag Stuttgart · New York

Long-Term Results of the Modified Russe II Procedure in Scaphoid Non-Unions of the Proximal Pole

G. E. Wozasek1 , C. Radler1 , V. Vécsei1
  • 1University of Vienna, Trauma Centre, Vienna, Austria
Further Information

Publication History

Publication Date:
01 December 2005 (online)

Abstract

We present the long-term outcome of nine cases of proximal scaphoid non-union treated by the modified Russe II procedure including excision of the avascular proximal scaphoid pole, placement of a shaped iliac crest bone graft and internal fixation. The patients were re-examined after a mean follow-up of 16.7 years (ranging from 3.5 to 28 years) and subjective pain, objective range of wrist motion and grip strength as well as the radiological outcome were evaluated. Eight of the nine patients demonstrated very good and good clinical long-term results, despite the fact that the radiological outcome was rated good in only five cases. By restoring the anatomic shape of the scaphoid the modified Russe II procedure proved to be an effective and long-term reliable alternative in the difficult management of proximal pole non-unions of the scaphoid.

References

  • 1 Amadio P, Taleisnik J. Fractures of the Carpal Bones. In: Green DP (ed). Operative hand surgery. Churchill Livingstone, New York 1993; 1: 799-860
  • 2 Böhler J, Ender H G. Die Pseudarthrose des Skaphoids.  Orthopäde. 1986;  15 109-120
  • 3 Boyer M I, Schroeder H P von, Axelrod T S. Scaphoid nonunion with avascular necrosis of the proximal pole. Treatment with a vascularized bone graft from the dorsum of the distal radius.  J Hand Surg [Br]. 1998;  23 686-690
  • 4 Carter P R, Malinin T I, Abbey P A, Lluch A L. The scaphoid allograft: A new operation for treatment of very proximal scaphoid nonunion or for the necrotic, fragmented scaphoid proximal pole.  J Hand Surg [Am]. 1987;  14 1-11
  • 5 Dautel G. Komplikationen nach Skaphoidfrakturen. In: Merle M, Dautel G, Rehart S (eds). Die Chirurgie der Hand. Vol 2: Sekundäreingriffe. Traumatologie des Handgelenks. Thieme, Stuttgart 1999
  • 6 Gabl M, Reinhart C, Lutz M. et al . Vascularized bone graft from the iliac crest for the treatment of nonunion of the proximal part of the Scaphoid with an avascular fragment.  J Bone Joint Surg [Am]. 1999;  81 1414-1428
  • 7 Green D P. The effect of avascular necrosis on Russe bone grafting for scaphoid nonunion.  J Hand Surg [Am]. 1985;  10 597-605
  • 8 Haußmann P. Long-term results after silicone prosthesis of the proximal scaphoid pole in advanced scaphoid nonunion.  Handchir Mikrochir Plast Chir. 1999;  31 200-206
  • 9 Herbert T. The Fractured Scaphoid. Quality Medical, St. Louis 1990
  • 10 Jones K G. Replacement of the proximal portion of the scaphoid with spherical implant for post-traumatic carporadial arthritis.  J Hand Surg [Br]. 1985;  10 217-226
  • 11 Kukla C, Gaebler C, Breitenseher M, Trattnig S, Vécsei V. Occult fractures of the scaphoid.  J Hand Surg [Br]. 1997;  22 810-813
  • 12 Mack G, Kelly J P, Lichtman D M. Scaphoid non-union. In: Lichtman DM, Alexander AH (eds). The Wrist and its Disorders. WB Saunders, Philadelphia 1997
  • 13 Moser K D, Wozasek G E, Haller H. Interkarpale Teilarthrodese.  Handchir Mikrochir Plast Chir. 1988;  20 204-207
  • 14 Pechlaner S. Operationsverfahren „Russe II” bei Pseudarthrosen des Os scaphoideum.  Operative Orthopädie und Traumatologie. 1989;  1 263-271
  • 15 Pechlaner S, Beck E. Sanierende Operationsverfahren bei Scaphoidpseudarthrose.  Unfallchirurg. 1990;  93 150-156
  • 16 Robbins R, Ridge O, Carter P R. Iliac crest bone grafting and Herbert screw fixation of nonunion of the scaphoid with avascular proximal pole.  J Hand Surg [Am]. 1995;  20 818-831
  • 17 Russe O. Operationstechnik bei der Skaphoidpseudarthrose. In: Spier W, Buck-Gramcko D, Burri C (eds). Aktuelle Probleme in Chirurgie und Orthopädie. Hans Huber, Bern 1976; 73-76
  • 18 Streli R. Frakturen der Handwurzel: Konservative und Operative Behandlung.  Langenbecks Archive der Chirurgie. 1973;  3324 189-198
  • 19 Watson H K, Weinzweig J, Guidera P M, Zeppieri J, Ashmead D. One thousand intercarpal arthrodeses.  J Hand Surg [Br]. 1999;  24 307-315
  • 20 Wozasek G E, Moser K D. Percutaneous screw fixation for fractures of the scaphoid.  J Bone Joint Surg [Br]. 1991;  73 138-142

Gerald E. WozasekM. D. 

University of Vienna · Medical School · Trauma Centre

Währinger Gürtel 18-20

1090 Vienna

Austria

Phone: +43/1/4 04 00 59 25

Email: Gerald.Wozasek@akh-wien.ac.at