THE TREATMENT OF SCAPHOID NONUNION USING THE ILIZAROV FIXATOR WITHOUT BONE GRAFT

Abstract

Objectives: Evaluating the efficacy of the Ilizarov fine-wire distraction/compression technique in the treatment of scaphoid nonunion (SNU), without the use of bone graft.

Design: A retrospective review of 15 consecutive patients in one centre.

Patients and Methods: 15 patients; 14 males, with a mean SNU duration of 13.9 months. Following frame application the treatment consisted of three stages: stage one – the frame was distracted 1mm per day until radiographs showed a 2–3mm opening at the SNU site (mean 10 days); the SNU site was then compressed for 5 days, until the fragments were in contact., the third stage involved immobilization with the Ilizarov fixator for 6 weeks.

Results: Radiographic and clinical bony union was achieved in all 15 patients after a mean of 89 days (70–130 days). Mean modified Mayo wrist scores improved from 21 to 86 at a mean follow-up of 37 months (24 –72 months), with good/excellent results in 12 patients. All patients returned to their pre-injury occupations and levels of activity at a mean of 117 days. Three patients suffered superficial K-wire infections, which resolved with oral antibiotics.

Conclusions: In these study group with this technique we achieved bony union without the need to open the SNU site and without the use of bone graft.