The evaluation of functional outcome in patiend applied outologous distal radius bone grafting and screw fixation at scaphoid nonunions

The Evaluation of Functional Outcome in Patiend Applied Outologous Distal Radius Bone Grafting and Screw Fixation at Scaphoid Nonunions Aim: This study aimed to evaluate the clinical and functional results in patients with scaphoid non-union to whom distal radius autogenous bone graft, headless canulated compression screw (Acutrak or Herbert) were applied for fixation. Study Plan: Retrospective evaluation was made of 64 patients (58 male, 6 female; mean age 29.42 years) with scaphoid non-union to whom autogenous distal riadius bone graftand screw (Acutrak or Herbert) were applied for fixation, between august 1997 and March 2014. In all patients, measurements in both wrists were taken by goniometer of flexion, extension, and degrees of radial and ulnar deviation. Bilateral wrist muscle strength was measured by dynamometer. The fractures were evaluated radiologically by the Herbert-Fisher system and the clinical and functional results by the Herbert-Fisher classification system and by the modified Mayo wrist scoring system. Results: Non-union was on the dominant side in 38 cases; 39 in the right hand and 25 in the left hand. The mean time from fracture to surgery was 18.9 months (2–180 months). The fracture was observed to be in the mid-section in 28 cases (43.8%), in the proximal third in 30 cases (46.9%) and in the distal third in 6 case (9.4%). The mean follow-up period was 26.9 months (range 7-60 months).Mean flexion degree 77.580, extansion 54.840, radial deviatıon 11.80 and ulnar deviatıon 17.580. In operated sıde. Compared to the healthy hand no function loss of more than %15 was observed in operated side.12 patient excellent results (%18.8),in 28 patient good result (%43.8), in 12 patient middle results (%18.8) and in 12 patient poor results (%18.8) to identified in according to our evaluation scale. One patient had to be taken reoperation due to infection. In 11 patient,was seen impingement and degenerative findings and has done radial styloidektomy and debridmant to 4 patients. In 8 cases (%12.5) was seen avascular necrosis. Mean post operative grip strength was determined as 38.4 (range:15-47). Conclusion: Scaphoid nonunions cause permanent changes and poor functional results at wrist and the patients restricted daily activities quality of life falls. Autogenous distal radius bone graft and screw fixation can be considered a safe and successful treatment method.We find that satisfactory results are consistand with the literature. KeyWords: Scaphoid, non-union, bone graft, surgical treatment