Article
Arthroscopic Treatment of Scaphoid Non-union: A Case Report
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Published: | February 6, 2020 |
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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.