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The Journal of Bone and Joint Surgery, Vol 70, Issue 7 982-991, Copyright © 1988 by Journal of Bone and Joint Surgery, Inc

JOURNAL CONTENTS

Treatment of ununited fractures of the scaphoid by iliac bone grafts and Kirschner-wire fixation

HH Stark, TA Rickard, NP Zemel and CR Ashworth
Orthopaedic Hospital, Los Angeles, California.

Of 151 ununited fractures of the scaphoid that were treated with iliac bone grafts and Kirschner-wire fixation through a volar approach, all but four (97 per cent) healed in an average of seventeen weeks, Three of the four failures resulted from obvious technical errors. Neither the preoperative existence of necrosis of the proximal fragment nor the location of the fracture affected the results. When there was mild radiocarpal arthritis preoperatively, it did not progress postoperatively; if there was moderate radiocarpal arthritis preoperatively, progression seldom was seen if a radial styloidectomy was done. Displaced and unstable ununited fractures healed even if the deformity was not corrected completely. The principal benefit of the procedure was relief of pain rather than an increase either in motion of the wrist or in strength of grip.
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