Functional Outcome after Treatment of Scaphoid Nonunion Using Corticocancillous Iliac Bone Graft and Fixation with Serrated K-wires.

Background
To determine the functional outcome of treatment of scaphoid nonunion with serrated K-wires and corticocancellous iliac bone graft.
Patients and Methods
Eighteen patients with scaphoid nonunion were included, 14 males and 4 females. The right side was affected in 13 patients while the left was affected in 5 patients. The duration of patient complaint was 24±14.54 (Range 8-48) months. Waist fracture was present in 13 patients while proximal pole was affected in 5 patients. The average age was 31±8.33 (Range 18-47) years. The pre-operative Modified Mayo Wrist Score (MMWS) was 54.16±15.07 (Range 40-70). The pre-operative scapholunate angle was 67.2±8.3 degrees (Range 78-50). All patients were operated through the anterior approach to the scaphoid. Two 0.045 serrated K-wires were used for fixation in all cases with the the use of corticocancellous iliac bone graft.
Results
All patients were united except one (Rate 94%). The duration for union was 4.77±1.16 (Range 3-8) months. The MMWS improved from 54.16±15.07 (Range 40-70) pre-operatively to 85.55±8.89 (Range 60-95) post-operatively (P-value<0.001). Sixteen patients were graded as satisfactory result being 7 as excellent and 9 as good. Two patients were graded as unsatisfactory result being one as fair and one as bad. The scapholunate angle improved from 67.2±8.3 degrees (Range 78-50) pre-operatively to become 42±6.5 degrees (Range 65-37) post-operatively.
Conclusions
Serrated K-wires and coticocancellous iliac bone graft through anterior approach is an effective method for treatment of scaphoid nonunion.