AVASCULAR NECROSIS OF THE SCAPHOID TREATED BY TOTAL EXCISION AND RADIAL ADVANCEMENT OSTEOTOMY

Total scaphoid excision and radial advancement osteotomy has been inve stigated in a cadaveric and clinical study. In three below-elbow fresh amputation specimens, the technique was utilized and stability was ch ecked by radiographs. Instability on ulnar deviation was prevented by extensor carpi radialis longus tenodesis. Four patients were treated i n this may. The wrist was immobilized in a below-elbow splint for 45 d ays, then active motion was encouraged. After 10 months, three patient s had excellent results and one patient had good result using the crit eria of Cooney et al (1987).