Evaluation of the Functional and Radiological Outcome in the Treatment of Scaphoid Fracture Non-union after Bone Grafting with and without Fixation

Scaphoid fracture, as the most common fracture of the wrist, is complicated sometimes by non-union. The purpose of this study is to compare radiologic and functional outcomes in patients with scaphoid non-union who were treated by bone graft with fixation (pin or screw) or without fixation. In this cohort retrospective study, all patients with scaphoid non-union who presented and underwent operation from 2004 through the first six-months of 2009 in Shafa Yahayaian hospital were invited. Of the total 58 patients, 37 patients (39 non-unions) were included. Using wrist radiography (AP and lateral) and Modified Green-OBrien classification, union and functional outcomes were assessed respectively and results were compared with Chi-square test. Data analysis was done with SPSS V.13.0. Twenty-seven surgeries (69.2%) were done by fixation and 12 (30.8%) without fixation. In fixation group, 25 cases (92.6%) had union and in the other group(non fixation) all 12 patients (100%) had union (p = 0.4). In the fixation group 2 patients had fair, 17 had good, and 8 had excellent results. In the other group, one, 7, and 4 patients had fair, good, and excellent results, respectively (p = 0.9). Decision to perform fixation or not is based on operation findings, non-union type and surgeon's opinion and experience. Based on the obtained results, there was no significant difference regarding union rate and functional class between the two studied groups