Is there a correlation between the scaphoid’s morphology, the development of arthritis and the long-term functional outcomes in patients treated for nonunion with a bone graft? - 19/01/25
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Abstract |
Introduction |
The main complication following scaphoid fracture is nonunion, which requires a surgical intervention to prevent the development of Scaphoid Nonunion Advanced Collapse (SNAC) wrist arthritis. In some cases, the bone eventually heals in malunion. There is a lack of published data on the clinical and radiological consequences of these malunions. The aim of our study was to determine if there was a correlation between the scaphoid’s shape after bone graft treatment of a nonunion and the development of arthritis and to determine the strength of the correlation between the shape and clinical outcomes. Hypothesis: There is no correlation between the scaphoid’s shape and the development of radiocarpal arthritis nor the clinical and functional outcomes in the long-term after nonunion treatment.
Patients and methods |
Fifty patients having a mean age of 27.5 ± 10.3 years (19–68) were included and followed for a mean of 92.2 ± 58.6 months (18–244). The scaphoid’s shape was determined using CT data (LISA: lateral intrascaphoid angle, H/L: height/length ratio) and using radiographs (RLA: radiolunate angle). The clinical data (age, sex, dominant hand, smoking habits, occupation, work status at final follow-up), the operative data, potential complications and functional outcomes (DASH, MWS, PRWE) were collected during the final follow-up visit.
Results |
The mean RLA was 7.4 ± 11.1 ° (min −21; max +46), the mean LISA was 30.5 ± 5.8 (min 22 max 47) and the mean H/L was 0.6 ± 0.2 (min 0.5 max 0.8). The mean DASH was 17.7 ± 18.9 (min 0 max 63.6). PRWE was 26.3 ± 26.3 (min 0, max 127) and MWS was 82.7 ± 19 (min 25 max 100). There was no statistically significant correlation between the scaphoid’s shape and the development of arthritis (p = 0.38 for RLA, p = 0.24 for LISA, p = 0.38 for H/L), nor between the scaphoid’s shape and the clinical or functional outcomes at a mean follow-up of 7.7 years.
Conclusion |
In this study, the development of arthritis and the clinical outcomes were not correlated with the scaphoid’s shape after nonunion treatment by bone graft, whether vascularized or not.
Level of evidence |
IV; retrospective study.
Le texte complet de cet article est disponible en PDF.Keywords : Scaphoid malunion, Bone autograft, Lateral intrascaphoid angle, Radiolunate angle
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