Functional results and quality of life after bilateral scaphoid reconstruction: a case series

Arch Orthop Trauma Surg. 2013 Feb;133(2):283-6. doi: 10.1007/s00402-012-1642-0. Epub 2012 Nov 4.

Abstract

Unilateral scaphoid non-union remains a major problem, which can lead to major functional limitations. Until now there is no evidence of outcome of the rare case of bilateral scaphoid non-unions and in how far two-stage bilateral reconstruction affects functional results and the quality of life. Between 1997 and 2010, altogether four bilateral scaphoid non-unions were treated in the centre and retrospectively analyzed. The mean follow-up was performed 36.8 months after reconstruction. The measures included analysis of patient data, analysis of functional measures and quality of life after follow-up. The reconstructions were performed with implantation of a free, non-vascularized iliac crest bone graft (4), osteosynthesis with implantation of a pedicled vascularized bone graft (3) and osteosynthesis with cancellous bone graft (1). The mean range of motion of the wrist was extension/flexion 111.3°. The average grip strength by JAMAR dynamometer showed right versus left sight 32.7 kg (±3.5) versus 33.7 (±2.9). The evaluation of the DASH score resulted in 11.6 (±12.5), the SF36 scale in 87.1 (±9.2) points. The present case series for the first time demonstrated functional mid-term results of the rare event of bilateral scaphoid reconstruction after non-union. With respect to the impact on one affected hand, functional results, DASH score and quality of life are excellent and thus justify good prognosis in patient education after injury.

MeSH terms

  • Adult
  • Bone Transplantation
  • Fractures, Ununited / surgery*
  • Hand Strength
  • Humans
  • Ilium / transplantation*
  • Male
  • Plastic Surgery Procedures
  • Quality of Life
  • Range of Motion, Articular
  • Recovery of Function
  • Retrospective Studies
  • Scaphoid Bone / injuries*
  • Scaphoid Bone / surgery*
  • Wrist Injuries / surgery*
  • Wrist Joint / surgery*
  • Young Adult