WRIST PAIN ? SELF TESTING
About Prof. Christophe Mathoulin
- THE BOOK OF WRIST ARTHROSCOPY TECHNIQUES Author : Prof. Christophe MATHOULIN Release date : 17 Avril 2015 Wrist Arthroscopy Techniques is a step-by-step, anatomically ...
- Editorial & Oratory involvements EDITORIAL BOARD - Member of Editorial board of Journal of Hand Surgery American Issue - Member of Editorial Board of ...
- Member : Learned Societies of Medicine - Full member of "Société Française de chirurgie de la Main" - Full member of the "Surgeon Academy" - Founder ...
MAPS from Hand Institute Paris France
Proximal pole reconstruction
Arthroscopic Bone Grafting for Scaphoid Nonunion
Introduction: Scaphoid fractures are often initially missed and then diagnosed only once nonunion manifests. Because the natural history of these fractures results in radiocarpal arthritis and ultimately midcarpal arthritis, they must be surgically treated. However, choice of treatment strategy is still controversial.
The techniques range from less invasive, such as percutaneous fi xation, to more invasive, such as autologous bone grafting from the iliac crest or vascularized bone grafts. Surgical treatment of nonunions can be minimally invasive with arthroscopy. This simplifi es postoperative recovery, reduces complications, and preserves the wrist’s capsule–ligament complex, and thus the scaphoid’s precarious vascularization.
Conclusion: Scaphoid nonunion is a common problem because the initial fracture can go undetected, and the bone is poorly vascularized. It can eventually progress to scaphoid nonunion advanced collapse (SNAC) and must be treated surgically before osteoarthritis set s in. Arthroscopic bone grafting is a simple, reliable technique that preserves vascularization, especially in patients with proximal pole nonunion.