Quemener-Tanguy Alexandre, Vigié Rémy, Koelhy Axel, Ballet Safire, De Villeneuve Bargemon Jean-Baptiste, Levadoux Michel
Orthopedic, Traumatology, Plastic and Hand surgery Unit and CIC IT 808 University Hospital of Besançon, Besançon F25033, France.
Chirurgie de la main, du poignet et du coude, Hôpital Privé Saint Roch, Toulon, France.
J Hand Surg Eur Vol. 2025 Jul;50(7):914-921. doi: 10.1177/17531934241312333. Epub 2025 Jan 24.
We compared the outcomes of two groups of patients with scaphoid nonunion treated with arthroscopic cancellous bone grafting. In group 1, K-wires were introduced beforehand and in group 2 after debridement and packing bone grafts in the nonunion site. Our hypothesis was that the percentage of unions would be higher in group 2. We conducted a retrospective, single-centre comparative study of two consecutive series of patients. Seventeen patients in group 1 were operated between 2011 and 2015 and 25 patients in group 2 between 2015 and 2022. At 3 months, there was already a significant difference in consolidation, with three fractures united in group 1 and 21 in group 2. At 6 months, 10 patients (59%) united in group 1 and 24 (96%) in group 2. Debridement of the nonunion site without K-wires in place may allow a more thorough debridement and extensive filling of the defect with bone graft. If an arthroscopic technique is used for scaphoid nonunion, we do not recommend prior fixation with K-wires. III.
我们比较了两组采用关节镜下松质骨移植治疗的舟骨不愈合患者的治疗结果。在第1组中，预先插入克氏针；在第2组中，在清创并在不愈合部位植入骨移植材料后插入克氏针。我们的假设是第2组的愈合率会更高。我们对连续的两组患者进行了一项回顾性单中心对照研究。第1组的17例患者于2011年至2015年间接受手术，第2组的25例患者于2015年至2022年间接受手术。在3个月时，骨折愈合情况就已存在显著差异，第1组有3例骨折愈合，第2组有21例。在6个月时，第1组有10例患者（59%）愈合，第2组有24例患者（96%）愈合。在不预先放置克氏针的情况下对不愈合部位进行清创，可能会使清创更彻底，并用骨移植材料更广泛地填充缺损。如果采用关节镜技术治疗舟骨不愈合，我们不建议预先用克氏针固定。III.
