DOS 2018

DOS Kongressen 2018 · 115 Arthroscopically assisted bone grafting reduces time to healing of scaphoid non-unions compared to percutaneous screw fixation alone. Robert Gvozdenovic, Stig Joerring, Rasmus Wejnold Joergensen, Claus Hjort Jensen Herlev-Gentofte University Hospital of Copenhagen, Department of Orthopedics, Hand Surgery Unit Background: Minimally invasive techniques have been recommended in the treatment of painfull but stable scaphoid non-unions. Purpose / Aim of Study: The purpose of this study was to determine if ar- throscopically assisted bone grafting gave superior results in healing comparing to percutaneous screw fixation. Materials and Methods: 164 consecutive patients with scaphoid non-unions were retrospectively analyzed. 148 were treated with the open grafting tech- niqes either with iliac or distal radius bone, leaving 16 patients treated with minimally invasive surgery. In the group treated percutaneously (n=8), the time from injury to surgery was 2,3 months (range 2 – 4 months) and it was 27,3 months (range 3- 180 months) in the arthroscopic group (n=8). The mean age was 42,5 years in the percutaneous group, 22 years in the arthroscopic, (range 20-66) / (range 16-32), respectively. In all cases, the Mini Acutrac headless fully threaded compression screw was used. Healing was assessed clinically and radiographically at a minimum follow- up of 12 weeks (range 4-56 weeks). Data were calculated with two-tailed Mann- Whitney U test based on p-value of p<0.05 which was considered statistically significant. Findings / Results: We recorded no complications in any of the groups. All pa- tients treated arthroscopically received cancellous bone grafting from the distal radius. They healed at median of 7,8 weeks (range 5-18). 7 patients in the per- cutaneous group healed at mean of 10,8 weeks (range 7-24). Mann Whitney U test showed the u value of 11, the critical value of U to be 13 (p<0.05), thus significantly faster healing in the arthroscopically treated group. Conclusions: Arthroscopically treated patients achieved faster healing. Local bone grafting is considered as the main reason for this outcome. Younger popu- lation in the arthroscopically treated group may influenced the result. 56.