Treatment of the scaphoid humpback deformity – is correction of the dorsal intercalated segment instability deformity critical?. (January 2018)

• Record Type: Journal Article
• Authors: Mathoulin, Christophe L.; Arianni, Margareta
• Is Part Of: Journal of hand surgery. Volume 43:Number 1(2018)
• Page Start: 13
• Page End: 23
• Publication Date: 2018-01
• Subjects: Scaphoid nonunion -- dorsal intercalated segment instability deformity -- scaphoid malunion -- bone graft; 617.575059
• DOI: 10.1177/1753193417739526
• Languages: English
• ISSNs: 1753-1934

Abstract

Treatment of scaphoid fractures has been focused mainly on achieving union, with less attention to restoring normal scaphoid shape and orientation. Malalignment of one carpal bone will disrupt the kinetics of the entire wrist. The dorsal intercalated segment instability deformity associated with scaphoid waist nonunion is a nondissociative form of carpal instability. It has to be reduced in the treatment of scaphoid waist nonunions to avoid kinetic problems that will lead to arthritic changes. Computerized tomography scanning has become indispensable to visualize the humpback deformity clearly. Different techniques may be used to restore the normal anatomy of scaphoid, from non-vascularized graft to arthroscopic bone grafting, and also the option of vascularized bone grafting.