An observational study in Orthopedic, sponsored by Taipei Veterans General Hospital, Taiwan. Status unknown at 1 site in Taiwan. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2018-10-10.
Sponsored by Taipei Veterans General Hospital, Taiwan · Observational
The treatment for scaphoid proximal pole nonunion remains challenging due to the poor vascularity in the proximal pole fragment, associated SL injury and the technique of fixation. Vascularized bone grafts and non-vascularized iliac bone graft have been used in patients with scaphoid proximal pole nonunion, but the indication has not been well clarified. Alternatively, we have been treating such patients with vascularized bone graft , or non-vascularized bone graft with screw or k-wire fixation with considerable success. The purpose of this study is to evaluate and analyze retrospectively the surgical efficacy of our procedure.
Scaphoid nonunion are common and operative treatment with bone graft was reported to have good result. However, the treatment for proximal pole nonunion remains controversial. There are some patterns of pathoanatomy combined with scaphoid fracture, like SL ligament tears, which could not be easily identified or treated initially. The proximal pole nonunion was near SL joint. Therefore, proximal pole nonunion may result in DISI instability. Furthermore, proximal pole nonunion was identified as a poor prognostic factor in scaphoid nonunion.
In the past 10 years, we have some different technique, like VBG, arthroscopic bone graft to achieve good results. Some studies revealed that significantly better SL stability was achieved with ARASL. We also used ARASL with BG to improve proximal pole union. However, it is not clear which method would be appropriate for proximal pole nonunion. We retrospectively investigated the functional outcome and radiological results after at least 2-year follow-up to clarify the surgical efficacy of these procedures.
54 studies on the registry are indexed under Fractures, Ununited; 10 are open to participants now.
This study's planned enrollment of 10 is below the median of 100 across 19 observational studies indexed under Fractures, Ununited.
Browse Fractures, Ununited studies →Taipei Veterans General Hospital, Taiwan is the lead sponsor of 325 studies on the registry; 72 are open to participants now.
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Using arthroscopic or open fixation combined with bone graft surgery for proximal pole scaphoid nonunion
Exclusion Criteria:
Disabilities of the Arm, Shoulder, and Hand (DASH) score
30-item disability/symptom scale, scored 0 (no disability) to 100
Time frame: averaged 2 years
Radiographic examination
The union was defined as trabecular bridging across the fracture site
Time frame: averaged 2 years
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Taipei Veterans General Hospital, Taiwan