The treatment of scaphoid nonunion - A review of a novel technique using precision bone grafting compared with Herbert screw fixation and bone graft

We have retrospectively reviewed the results of 40 consecutive patients wit h nonunion of the scaphoid treated by the senior author (PG) between 1993 a nd 1996. These comprised two groups of patients. Group 1 comprised 20 patie nts treated between 1993 and 1994, with a Herbert screw and autograft, and Group 2, which also comprised 20 patients treated with the precision bone g rafting technique which we describe. The precision bone grafting technique employs simple instrumentation to harvest bone percutaneously from the ilia c crest and then insert it at the scaphoid nonunion site. The evaluation co nsisted of a clinical and radiological assessment of union and wrist functi on. Our review demonstrates a higher rate of union with the precision bone grafting technique than by the Herbert screw fixation with bone grafting.