ANTERIOR WEDGE-SHAPED BONE-GRAFT FOR OLD SCAPHOID FRACTURES OR NON-UNIONS - AN ANALYSIS OF RELEVANT CARPAL ALIGNMENT

For appraisal of anterior wedge-shaped grafts for the humpback deformi ty of the scaphoid, a retrospective study of 27 cases with old scaphoi d fractures or non-unions was carried out. 11 cases were treated with Herbert screw fixation and anterior wedge-shaped graft and the other c ases with other methods. For the assessment of carpal alignment, radio -lunate and scapho-lunate angles were measured with peri-operative rad iographs. For the clinical assessment, the scoring system of Cooney wa s applied. In 25 cases, primary bone union was obtained with one attem pt and in two cases, with the second operation. Union was achieved in a mean of 3.4 months. The post-operative wrist score ranged from 65 to 100 with an average 81.2 points. There was a statistically significan t relationship between the wrist score and the post-operative scapho-l unate angulation of the affected wrist. The humpback deformity of scap hoid non-union should be treated precisely with carpal realignment sur gery or anterior wedge-shaped bone graft.