26 papers · updated 2026-09-26 · Hand & Upper Extremity · All topics
The newest papers on scaphoid fractures and nonunion from the orthopaedic journals The Reduction reads, newest first, each with a one-line summary. The list is drawn from the digest’s archive and refreshed every week.
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Epidemiology and Clinical Implications of Scaphoid Morphology Based on Morsy Classification.
Type I scaphoids predominate at 80% prevalence in the general population; type II scaphoids show higher left-handedness but no other demographic differences.
Radioscaphoid Pressures and Carpal Kinematics After Wrist Ligament Sectioning.
Cadaver wrist testing showed that sectioning key dorsal and interosseous ligaments increases scaphoid/lunate malalignment and radioscaphoid joint pressure, supporting a mechanism for progression to SLAC wrist if untreated.
A dedicated axial fluoroscopic view for scaphoid screw placement correlated only modestly with CT and underestimated deviation, so it can flag eccentric trajectory intraoperatively but shouldn't be treated as a CT substitute.
Union outcomes and associated factors in adolescent scaphoid fractures.
In 77 adolescents with scaphoid fractures, union rates were high (82%) overall but lower with proximal pole location, displacement, delayed diagnosis, surgery, older age, and adverse scaphoid morphometry.
Radiographic Scaphoid Waist Index and Nonunion After Scaphocapitate Fusion for Kienböck Disease.
In a small retrospective cohort, lower scaphoid waist index trended toward higher nonunion risk after scaphocapitate fusion for Kienböck disease, but findings were imprecise and hypothesis-generating only.
Prospective study of 39 patients found all-arthroscopic curettage and nonvascularized bone grafting achieved 94.8% union in scaphoid nonunion with good function, though smokers had worse outcomes.
Surgery reduced scaphoid nonunion by half but showed only modest functional improvement and increased complications sevenfold; cast immobilization remains reasonable for undisplaced fractures.
Outcomes of Distal Radius Autograft in Adolescent Scaphoid Nonunion Repair.
In adolescent scaphoid nonunions, ORIF with distal radius autograft achieved union in all cases (94% by 6 months) with improved carpal alignment and good return to activity, supporting this as an effective treatment.
Four-corner and lunocapitate fusions show similar outcomes; lunocapitate preserves function better but has higher complication rates requiring further study.
Scaphoid nonunion fixed with nonvascularized autograft healed in 95%, with no difference between cancellous and corticocancellous graft, and bridging bone on early CT reliably predicts union.
Senile Scaphoids: Outcomes of Surgical Fixation for Scaphoid Fractures in an Elderly Population.
Elderly patients aged ≥60 achieve similar scaphoid fracture union rates and low complications as younger patients when surgically fixed, challenging age-based restrictions on operative treatment.
Scapholunate Injuries in the Context of Acute Scaphoid Fractures: A Systematic Literature Review.
Systematic review finds scapholunate ligament injuries frequently accompany acute scaphoid fractures (0–71% incidence), with arthroscopy most sensitive, though optimal detection and treatment remain unclear.
This critical review finds that current AI/machine learning models for detecting scaphoid fractures have significant methodological flaws and bias, limiting valid comparison to clinician accuracy.
Arthroscopic bone grafting in scaphoid fracture nonunion: Is it a universal solution?
This review finds arthroscopic bone grafting for scaphoid nonunion achieves union rates and times comparable to open surgery regardless of smoking, chronicity, or fracture location, though deformity correction may be inferior.
For early-stage SLAC/SNAC wrist arthritis, proximal row carpectomy and four-corner arthrodesis both preserve motion with similar outcomes, though PRC may offer better motion, fewer complications, and lower cost.
Bone Graft and Fixation Options in the Surgical Management of Scaphoid Nonunion.
Review outlines bone graft and fixation choices for scaphoid nonunion, guiding selection of nonvascularized, vascularized, or osteochondral grafts based on proximal pole viability and deformity.
Scaphoid Nonunions: Local Vascularized Bone Flaps.
Review article on using local vascularized bone flaps for scaphoid nonunion, noting they avoid microsurgical anastomosis and can achieve high union rates in select patients.
Traditional Bone Grafting in Scaphoid Nonunion.
Nonvascularized bone grafting remains an effective option for scaphoid waist and proximal pole nonunions when combined with adequate debridement, length restoration, and stable fixation.
Scaphoid fracture and nonunion: new directions.
This review covers modern management of acute scaphoid fractures and nonunion, noting a trend toward dual-screw fixation and favoring two screws without bone graft even with humpback deformity.
Scaphoid waist nonunion treatment with slight lengthening, bone graft, and K-wire fixation without compression achieves good union rates.
Treatment of upper extremity palsies, gunshot wounds and scaphoid nonunion: my preferred approaches.
An expert opinion piece outlines the author's preferred surgical strategies for treating upper extremity nerve palsies, gunshot wound injuries, and scaphoid nonunion.
Acute scaphoid fractures: making decisions for treating a troublesome bone.
This review highlights persistent uncertainty and debate across seven key decision points in diagnosing and managing acute scaphoid fractures, from imaging to fixation and union assessment.
Scaphoid Nonunion Vascularized Bone Grafting in 2021: Is Avascular Necrosis the Sole Determinant?
Scaphoid nonunion treatment decisions should consider multiple risk factors beyond avascular necrosis, including nonunion location, duration, and previous surgery, to guide vascularized bone graft use.
Two-Screw Fixation of Scaphoid Waist Fractures.
Review argues two-screw fixation of scaphoid waist fractures offers biomechanical and union-rate advantages over single-screw fixation, though robust clinical outcome data are still lacking.
Evaluation and Management of Carpal Fractures Other Than the Scaphoid.
This review covers diagnosis and management of non-scaphoid carpal fractures, emphasizing imaging and surgical indications to avoid nonunion, osteonecrosis, and arthritis.
Posttraumatic avascular necrosis occurs after femoral neck, humeral head, talar neck, and scaphoid fractures; diagnosis timing and treatment depend on specific anatomic location and collapse.
The vascularity of the scaphoid bone
Cadaveric injection studies show the scaphoid's proximal pole depends heavily on radial artery branches entering dorsally, explaining its vulnerability to avascular necrosis and favoring volar surgical approaches to preserve blood supply.
A new vascularized bone graft for scaphoid nonunion
Vascularized distal dorsoradial radius bone graft enables scaphoid nonunion healing with reduced immobilization time compared to conventional techniques.
Article on scaphoid malunion (no abstract available).
The effect of avascular necrosis on Russe bone grafting for scaphoid nonunion
In 45 scaphoid nonunion patients, Russe bone grafting succeeded in 92% with good proximal pole vascularity but failed in all cases of true avascular necrosis, determined intraoperatively by punctate bleeding.
Treatment of Scaphoid Fractures and Nonunions
This 2008 review covers current concepts in diagnosing and surgically treating scaphoid fractures and nonunions, including fixation techniques and vascularized bone grafting for avascular necrosis.
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