THE ARTHROSCOPIC TREATMENT OF AVASCULAR NECROSIS OF THE PROXIMAL POLEFOLLOWING SCAPHOID NONUNION

The authors describe a technique of treating scaphoid nonunions with a ssociated avascular necrosis consisting of arthroscopic resection of t he distal pole of the scaphoid combined with radial styloidectomy. The results at 2-year follow-up showed all three patients to have complet e relief of their mechanical pain and improvement in their range of mo tion as well as high satisfaction with the procedure. Modified Mayo Wr ist Scores were a mean preoperatively of 60 and postoperatively of 88. Postoperative radiographs showed no increase in the scapholunate gap. However, the capitolunate angle increased from a mean of 3 degrees to 13 degrees. There was no progression of degenerative changes noted. T he advantages of this technique include (1) minimal morbidity, (2) rel ief of mechanical pain, and (3) improved range of motion with no early degenerative changes. The rate and severity of degenerative change fo llowing this procedure remain unknown.