The comparison of results for the bone grafting in treatment of scaphoid nonunio‎n with and without avascular necrosis

Background: The varieties of treatment methods for the scaphoid nonunio‎n have always been a discussable issue for orthopaedic surgeons. The current study, considered to be review for treatment results of the patients who sustained the scaphoid nonunio‎n with or without avascular necrosis and compared these two groups clinically and radiologically. Methods: The clinical and radiologic files of the patients who sustained the scaphoid nonunio‎n and underwent surgical treatment between 2004 and 2009 in our hospital, were collected and in the final follow-up, 37 patients and 38 nonunio‎ns underwent physical exam, grip power test, DASH questionnaire and radiography. Results: Avascular necrosis was detected in 22 cases and 16 cases had no avascular necrosis changes. Following open reduction and bone grafing, unio‎n was seen in 36 cases, and nonunio‎n in 2 cases which one was in the avascular necrosis group and another in without avascular necrosis group. The comparison of the residual pain, range of motion, DASH score and grip power in two groups, did not show a meaningful difference (p>0.05). Conclusion: Although multiple studies indicated that in the presence of the avascular necrosis in the proximal fragment of the scaphiod, possibility of unio‎n in the conventional graft methods was lower than vascular pedicle grafts, but this study demonstrated that the conventional treatment method yet was associated with a considerable successs and a reliable treatment method.