Distal scaphoid resection arthroplasty for the treatment of degenerative arthritis secondary to scaphoid nonunion

Nineteen patients with chronic scaphoid nonunion and associated degenerativ e arthritis between the distal fragment and the radial styloid were treated by resection of the distal fragment. All patients had a dorsal intercalate d segment instability wrist collapse pattern with an average radiolunate an gle of -32 degrees and a 10% reduction in the carpal height, both of which changed minimally during the follow-up period. The duration of the nonunion averaged 12 years and the follow-up period averaged 49 months. Range of mo tion improved 85% and grip improved 134%. Thirteen of the patients experien ced complete pain relief. One patient required additional surgery and elect ed wrist arthrodesis. Resection of the distal fragment is not recommended f or patients with capitolunale arthritis. Two Of the 4 patients with capitol unate arthritis had persistent symptoms; 3 had progressive degenerative cha nges. (I Hand Surg 1999;24A:1196-1205. Copyright (C) 1999 by the American S ociety for Surgery of the Hand.)