Evaluation of outcomes in patients following arthroscopically assisted surgery of scaphoid nonunion

BackhroundsThe scaphoid is one of the most important bon esof the human wrist, and the mostcommon fracture of the wrist is related to it. Scaphoid surfaces are articulate. Dueto the wide articular communications and high mobility of scaphoid, any disorderhas a significant effect on the overall function of the wrist. On the other hand,delicate perfusion and lesssoft tissue attachments make it susceptible to nonunionand necrosis. Because this fracture is more common in young men, itsmorbidity affect active population of the community. The prevalence of scaphoid nonunion is%12. Symptoms include chronic pain, limited motion, swelling and weakness of thewrist, and may eventually lead to complications such as deformity, instability, anddegenerative changes. The most commonly used treatment is open surgery, whichhas consequences such as damage to soft tissue and small blood vessels, ligaments,volar capsule, and delayed onset of remission. While with arthroscopic surgery inaddition to lesssoft tissue and vesseles damage, Direct vision is possible to restorealignment of articular surfaces meticulously and detect accompanying damage . Inthis study, we recorded the radiographic and functional results and the complicationsof arthroscopic treatment of scaphoid nonunion in an organized manner.MethodsThis study was carried out on patients with isolated and non-complicated nonunionand follow-up for one year in terms of unionization (based on imaging methods)and function with the parameters of the range of active motion based on the anglebetween the forearm and the third metacarp (by hand goniometer), grip strength(by dynamometer), and the standard disability questionnaires such as Hand, Armand Shoulder (DASH) score and Patient-Related Wrist Assessment (PRWE) score andModified Mayo Wrist Score. Complications associated with the surgical procedurewere also carefully recordedResultsIn this study, 15 patients were examined, of which 12 had fractures in dominanthand, and 3 were in non-dominant hands. 10 patients had scaphoid wrist fracturewhile 5 patients in the proximal pole. According to simple radiographic findings, thefracture of all patients was satisfactory united after 3 months. None of the patientshad direct complications associated with surgical procedures such as ery sitesurginfection or sensory impairment. In terms of function, the mean range of motion andthe strength of wrist were compared in two parameters including grip and pinch.According to the patients answers to the DASH questionnaire, their satisfaction withtreatment was evaluated and in %47 of patients, the results were excellent, %40good and %13 were weak. Overall, the average score of patients was 13.54 and was equivalent to good function. According to the PRWE questionnaire, the satisfactionwas answered by patients with a mean score of 16.11. According to the MAYOscoring system, the performance of the wrist was evaluated and %27 of the patientshad excellent outcome, %27 had good, %40 had satisfactory, and %6 had poor result.ConclusionsAccording to the obtained data, the arthroscopic treatment of scaphoid nonunionseems to be an effective method with low complications and favorable results