Application of plate and screw internal fixation combined with bone grafting for the treatment of nonunion of scaphoid fractures
Objective To evaluate the clinical efficacy of plate and screw internal fixation combined with bone grafting for the treatment of nonunion of scaphoid fractures.Methods From March 2019 to September 2021,28 patients with nonunion of scaphoid fractures were treated with plate and screw internal fixation combined with bone grafting.Among them,8 patients underwent revision surgery for nonunion after previous screw internal fixation surgery,and 20 patients underwent initial surgery for nonunion of scaphoid fractures.The clinical and imaging datawere collected,and the visual analog scale(VAS),grip strength,joint range of motion,and Mayo score before and during follow-up were compared.Results After surgery,all 28 cases were follow-up for a period of 12 to 49 months,with an average of 26.4 months.All 28 cases of scaphoid fractures healed after surgery,with a duration of 8 to 12 weeks,with an average of 10.2 weeks.A total of 12 patients underwent internal fixation removal after surgery,of which 6 had an impact between the radial styloid process and the scaphoid plate,and the other 6 required internal fixation removal.All patients'VAS,grip strength,joint range of motion,and Mayo scores were significantly improved compared to before surgery.Conclusion The combination of plate and screw internal fixation and bone grafting can provide a reliable biomechanical environment for the healing of scaphoid fractures,and is an effective method for treating nonunion of scaphoid fractures.
Scaphoid boneFractures,ununitedInternal fixation with plate and screwBone grafting
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