A Comparative Study of Three Different Bone Grafting Methods for Treatment of Scaphoid Nonunion / 대한정형외과학회잡지

PURPOSE: Bone graft is a widely accepted surgical treatment for scaphoid nonunion. The purpose of this study was to analyze and compare the clinical outcomes of the three different bone graft techniques, Matti-Russe technique, Fisk-Fernandez technique and vascularized bone grafting. MATERIALS AND METHODS: This study involved 20 cases in 20 patients of established scaphoid nonunion who were treated with three different bone graft techniques and followed up for at least 1 year. We measured preoperative and postoperative pain, Mayo Modified Wrist Score (MMWS) and range of motion of the affected and normal side. For radiological evaluation we assessed bone union, avascular necrosis, and dorsal intercalated segment instability (DISI). RESULTS: There were no significant differences among the three groups with respect to the pain, MMWS, and range of motion. The union rate and correction of DISI also made no significant difference. The time to achieve bone union, which averaged 2.6 months was significantly decreased in the vascularized bone graft group than in the other two groups. CONCLUSION: All three methods were proper surgical procedures for treatment of scaphoid nonunion because there was no statistically significant difference in clinical and radiological outcomes. Among these three methods the vascularized bone grafting had the shortest time to achieve bone union so it could result in the fast functional recovery of the patient.

A Comparative Study on the Treatment of Scaphoid Nonunion with Matti-Russe Technique and Fisk-Fernandez Technique / 대한정형외과학회잡지

PURPOSE: Established scaphoid nonunion may lead to carpal instability and osteoarthritis. The purpose of this study is to compare the clinical and radiological results of the osteosynthesis between Matti-Russe group and Fisk-Fernandez group. MATERIALS AND METHODS: Our retrospective study included 21 nonunion cases in 20 patients treated by Matti-Russe or Fisk-Fernandez technique from September 2001 to August 2006. The mean duration of follow up was 31 months. Based on the questionnaire which included clinical information and the radiologic evaluation, we compared the objective and subjective results between two surgical groups. RESULTS: There were no significant differences between two groups in respect of the postoperative satisfaction and the pain. Both the range of motion and the grip power decreased compared to that of the unaffected side, but there were no significant differences between two groups. Also, there were no significant differences in the union rate and the rate of successful correction of DISI deformity. In all cases in which DISI deformity was detected preoperatively, the deformity was corrected postoperatively. There were 7 cases of osteoarthritis, but among them only one case appeared newly after the surgery. CONCLUSION: There were no significant differences between two surgical groups in clinical and radiological results. Both techniques were effective in achieving bony union and functional recovery.

Treatment of Scaphoid Nonunion with Matti / 대한정형외과학회잡지

The scaphoid is the most commonly fractured carpal bone and the nonunion of the scaphoid has continued to represent a challenge to the surgeon who treats hand injuries. The are many treatment modalities and the technique of bone grafting described by Otto Russe in 1960, which is quite appropriately called the Matti-Russe procedure, has become a well-accepted method of treating nonunion of the scaphoid. And the results of this method has been presented by several authors. At the Department of Orthopedic Surgery, Seoul National University Hospital, From May 1985 to September 1988, ten cases of the scaphoid nonunion had been treated by Matti-Russe procedure and followed up more than 1 year. Fracture healing was observed in all ten cases. Seven patients were totally free of pain both at rest and at excercise and three patients noted moderate pain at excercise. All patient were satisfied with the results of operation and none felt worse.