일차 수술이 실패한 주상골 불유합에 대한 재유합술

Abstract

Purpose: The purpose of this study was to evaluate the outcomes of revision osteosynthesis using Herbert screw fixation combined with autogenous cancellous bone grafting for scaphoid nonunions after failed primary surgery. Materials and Methods: Twelve patients who underwent revision osteosynthesis for a scaphoid nonunion after a mean of 13.6 months following primary surgical failure were studied. There were 9 waist fractures and 3 proximal fractures. The revision osteosynthesis was performed using autogenous iliac cancellous bone grafting combined with Herbert screw fixation. Results: Union was achieved in 11 of 12 cases. The results of eleven united cases were clinically satisfactory at the mean follow up of 16.9 months after revision. The motion range of wrist joint improved: average flexion was 51°, average extension was 65°, average radial deviation 15°, and average ulnar deviation was 21°. Conclusion: Herbert screw fixation and autogenous iliac cancellous bone grafting was proved to be a useful method as a revisional operation for a scaphoid nonunion after failed primary surgery