Non-United Fracture Scaphoid Surgery, Simple Step by Step Precise Technique

For many years, we have been using a simplified reconstruction technique for scaphoid non-unions that involves the use of precise iliac bone graft first described by modified Matti-Russe technique, based on consideration of the three elements of bone healing, deep knowledge of the applied anatomy, vascularity and biomechanics of the carpal bone. We have retrospectively reviewed the results of 69 consecutive patients with nonunion of different sites of the scaphoid treated by one senior author between 2005 and 2018. The objectives of our technique are to apply simple step by step technique that can be utilize by an average orthopedic and hand surgeon starting from simple careful volar soft tissue dissection not to add insult to vasculature, simple reduction, excision of the fibrous none union part of the fracture, preparation and micro fractures of the fracture bed, precise bone graft harvesting, simple fixation and closure. This technique is simple, fast and precise, only used for an established scaphoid nonunion without significant arthritis, chronic non-union with bone cyst formation and may be used in recurrent non-union after failed surgery associated with DISI carpal deformity but no significant radiocarpal or mid carpal arthritis.