Kumar Das Tapan, Mishra Jitendra, Panigrahy Subham, Pani Sunit, Mishra Spandan
Department of Orthopaedics, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, IND.
Cureus. 2024 Sep 6;16(9):e68826. doi: 10.7759/cureus.68826. eCollection 2024 Sep.
Purpose This study details the functional results, patient satisfaction, and cost-effectiveness of patients treated with Fisk-Fernandez surgery using iliac crest graft and K-wire for scaphoid nonunion. Materials and methods This study involved a retrospective analysis conducted between November 2022 and August 2024. Forty-two patients diagnosed with scaphoid nonunion were treated using a surgical approach that included autologous bone grafting combined with K-wire fixation to promote bone healing and stability. To enable comparison, the QuickDASH-9 score, visual analog scale (VAS), and patient-rated wrist evaluation (PRWE) score were used for both preoperative and postoperative evaluations at the final follow-up. Results Our study group received treatment for an average of 16 months post-injury, ranging from 6 to 28 months. The average time of union was six months, ranging from four to 18 months. The study significantly improved QuickDASH-9 scores, grip strength, PRWE scores, and VAS for pain. The study reported no complications, and all patients returned to their basic activities of daily living. Conclusion Results of this study show that displaced scaphoid nonunions can be successfully treated with K-wire fixation combined with iliac crest bone grafting utilizing the Fisk-Fernandez approach.
目的 本研究详细阐述了采用髂嵴植骨和克氏针治疗舟骨不愈合的菲斯克 - 费尔南德斯手术患者的功能结果、患者满意度和成本效益。材料与方法 本研究为2022年11月至2024年8月间进行的回顾性分析。42例被诊断为舟骨不愈合的患者接受了一种手术方法治疗，该方法包括自体骨移植联合克氏针固定以促进骨愈合和稳定性。为便于比较，在最终随访时使用QuickDASH - 9评分、视觉模拟量表（VAS）和患者自评腕关节评估（PRWE）评分进行术前和术后评估。结果 我们的研究组在受伤后平均接受治疗16个月，范围为6至28个月。平均愈合时间为6个月，范围为4至18个月。该研究显著改善了QuickDASH - 9评分、握力、PRWE评分和疼痛VAS评分。该研究报告无并发症，所有患者均恢复了基本日常生活活动。结论 本研究结果表明，采用菲斯克 - 费尔南德斯方法，克氏针固定联合髂嵴植骨可成功治疗移位性舟骨不愈合。
