Is Bone Grafting Unnecessary in the Treatment of Cystic Scaphoid Pseudoarthrosis? Je kostní štěp nezbytný při léčbě cystické pseudoartrózy skafoidea?
Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca, cilt.90, sa.6, ss.422-426, 2023 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 90 Sayı: 6
- Basım Tarihi: 2023
- Doi Numarası: 10.55095/achot2023/051
- Dergi Adı: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE
- Sayfa Sayıları: ss.422-426
- Anahtar Kelimeler: scaphoid bone, nonunion, fracture fixation, internal, bone grafting, bone screws
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Purpose of the study The basic aim of the treatment of cystic nonunion is to provide stable fixation and mechanical compression to increase union, but there is no consensus on whether to perform bone grafting in the cystic area or not. The aim of this study was to compare the clinical and radiological results of patients with cystic scaphoid non-union who received open grafting, and internal fixation and those treated with percutaneous fixation without grafting. Material and Methods A retrospective evaluation was made of patients included those determined radiologically with Slade and Dodds grade IV scaphoid cystic non-union. Two different surgical procedures were performed. Percutaneous screw fixation was carried out on the patients in group 1. Open curettage–grafting and screw fixation were performed on the patients in group 2. Group 1 was comprised of 16 patients treated with percutaneous screw fixation, and group 2 was comprised of 17 patients who had open curettage–grafting and screw fixation. Results In the radiological evaluation at the final follow-up examination, union was determined in 12 of the 16 (75%) patients in group 1 and 15 of the 17 (88%) patients in group 2. There was no statistically significant difference between the two groups in terms of union, functional outcomes and complication rates. Discussion In the current study, the union rate was higher in the patients who had open curettage–grafting and fixation with a head-less screw (88%) than in those with percutaneous screw without grafting (75%), but the difference was not determined to be statistically significant. The union rate of the group that received grafting was similar to the rates reported in the literature. Conclusions We think that both of these techniques may be successfully used for cystic scaphoid nonunions but percutaneous technique should be preferred as it is minimally invasive. Nevertheless, there is a need for further prospective, randomised studies with larger series to have better comparisons.