Article

The publications dealing with scaphoid non-union emphasize importance
of correction of the Dorsal Intercalated Segment Instability (DISI) to achieve
good functional results and to prevent osteoarthritis. The purpose of this study
was to assess, over 10 years follow-up, the functional outcomes of 25 patients
with scaphoid non-union surgery. X-ray and DISI deformity were assessed. METHODS:
Between 1994 and 1998, 53 patients underwent surgery for scaphoid non-union. Over
10 years follow-up, functional evaluation based on pain, QuickDASH and Mayo Wrist
Score was performed, and a physical examination including mobility, strength and
pain on the region of the scaphoid. Outcomes on X-rays were assessed by searching
osteoarthritis damages and by measuring carpal height index and intracarpal
angles. RESULTS: Eight patients had pain on the scaphotrapeziotrapezoidal joint
without degenerative lesions on radiography. Compared to other patients, they had
worse functional results, decrease of scapholunate angle, decrease of the DISI
and increase of carpal height. CONCLUSIONS: The correction of the DISI is not
always associated with good functional results. Although there were no
osteoarthritic changes on the radiography, residual pain may be related to
affection of the scapho-trapezo-trapezoidal joint. Surgical treatment with
osteotomy of the scaphoid seems to be dangerous because of the moderate impact on
function for these patients.
CI - Copyright (c) 2011 Elsevier Masson SAS. All rights reserved.

Langue : FRANCAIS