Résumé
INTRODUCTION@#Scaphoid nonunion is one of the most difficult fractures to treat. Restoration of carpal alignment and fracture stability can provide good outcomes in the management of scaphoid nonunion.@*OBJECTIVE@#The purpose of this study was to determine the functional outcomes of scaphoid nonunion associated with humpback deformity treated with anterior wedge bone grafting and internal fixation.@*METHODS@#A retrospective review of all patients with scaphoid nonunion treated with anterior wedge bone grafting from January 1, 2014 to December 31, 2019 was done. Outcome measurements were time to union, pre- and postoperative FIL-DASH scores, grip, pinch, and scapholunate angle improvement. The other outcome measures were pain and complications.@*RESULTS@#A total of 12 patients were included in the study. All were males with an average age of 27.4 years (SD, 9.6). The average delay to surgery was 9.5 months (SD, 10). All fractures were at the waist, except for three proximal pole fractures, none had established avascular necrosis. Eleven out of 12 scaphoids healed at an average of 11.5 weeks (SD, 3.2). There was a significant improvement in the FIL-DASH score and scapholunate angle after surgical reconstruction. Grip strength averaged 83% of the contralateral side. All returned to previous normal activities. One patient with persistent proximal pole nonunion was managed with a 4-corner arthrodesis.@*CONCLUSION@#Anterior wedge bone grafting for scaphoid nonunion restored the scapholunate angle and was able to establish union in 11 of 12 scaphoid nonunions with good outcomes.
Résumé
Objective@# The present study was designed to evaluate the use of inverted-L osteotomy of ramus combined with iliac bone graft for the treatment of mandibular hypoplasia inadult patients.@*Methods@#Intraoral or extraoralinverted-L osteotomy of ramus and iliac crest bone grafting were used for the treatment of mandibular hypoplasia in 11 adult patients (aged 19 to 29 years) from 2010 to 2016. Data were collected from the patients’ records, photographs andradiographs.@*Results @#The height and width of the mandibular ramus were significantly augmented by inverted-L osteotomy and iliac crest bone grafting with minimal complications in all patients, resulting in remarkable improvements both in facial appearance and occlusion.@*Conclusions @#Our preliminary results showed that the inverted-L osteotomy of ramus and iliac crest bone grafting is safe and effective, and should be considered as a good alternative for the patients with mandibular hypoplasia.