gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

Arthroscopic Treatment of Scaphoid Non-union: A Case Report

Meeting Abstract

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  • presenting/speaker Gino Francis Baylon - University of Santo Tomas Hospital, Sampaloc, Philippines
  • John Hubert Pua - University of Santo Tomas Hospital, Sampaloc, Philippines

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-1597

doi: 10.3205/19ifssh0003, urn:nbn:de:0183-19ifssh00032

Published: February 6, 2020

© 2020 Baylon et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objectives/Interrogation: Scaphoid fractures are one of the most common carpal bone fractures, with a higher incidence occurring in young men. Due to its tenuous blood supply, the scaphoid is at risk for avascular necrosis after a fracture. The primary risk factor for scaphoid non-union is fracture displacement; other risk factors are delayed diagnosis, inadequate immobilization, fracture location, and poor blood supply. The open approach using corticocancellous bone grafts, either vascularized or non-vascularized, has been the gold standard in the treatment of scaphoid non-union. The arthroscopic technique for the treatment of scaphoid non-unions is challenging, and requires extensive experience. However, the advantage of the arthroscopic technique as a minimally invasive technique continues to evolve. The goal of arthroscopic-assisted surgery of scaphoid fractures is to reduce displaced fractures without an open incision and to allow stable fixation for early range of motion until union is achieved.

Methods: This is a case of a 22-year-old male, right-handed, collegiate basketball varsity player who had a history of fall on his outstretched left hand that resulted to a fracture of the proximal pole of the scaphoid. The patient was advised surgery but was lost to follow-up until 3 years after when he presented with chronic wrist pain due to non-union of the scaphoid fracture.

Results and Conclusions: To the authors' knowledge, this is the first case of scaphoid non-union managed arthroscopically in the Philippines. The summary of the results showed radiographic union at day 50 post-surgery and 0-65 degrees range of motion for both wrist flexion and extension with grip strength at 24 kilograms force.