Results of treatment of ununited fractures of scaphoid bone by iliac bone graft and Kirschener wire fixation

ABSTRACT

Fractures of the scaphoid comprise 70% to 80% of injuries to carpal bone. Studies suggest that only 5% to 110% of these fractures proceed to non-union. This risk of delayed healing or non-union have been attributed to delay in beginning treatment, inadequate immobilization, displacement of the fragments, instability due to ligamentous injury or inadequate blood supply of the proximal fragment. Non-union of the scaphoid usually causes pain and weakness, which interfere with work and sport, also non-union would most probably result in carpal osteoarthritis. Sixteen patients with symptomatic non-union of the scaphoid had been treated by iliac bone graft and Kirschener wire fixation in Mansoura University Hospital. The patients presented with pain, limited range of wrist motion and weak grip strength. The average age was 27.6 years. The average time of delay before the operation was 32 months [3 months - 60 months]. The average duration of follow up period was 9 months. Union was achieved in 15 patients [93. 75%] at an average period of 20 weeks [16-28 weeks]. According to weightington wrist scoring system 13 patients [81 .25%] had excellent results, 2 patients [12.5%] had good results, one patient [6.25%] had poor results, and no fair results. Iliac bone graft and Kirschner wire fixation is an effective procedure for management of scaphoid non-union. It is simple, economic procedure that does not need special equipments and fixation does not add much to the operative time