Treatment of scaphoid waist nonunion with iliac crest bone graft and double Kirschner wire fixation: An observational clinical study

Background: Scaphoid fracture nonunion may be considered a serious problem if not treated properly. Nonunion can lead to resorption, loss of bone, and deformity. Iliac bone graft with double Kirschner wire (K-wire) fixation is an effective way to establish scaphoid union. This study aims to assess t...

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Main Authors: Navin Kumar Yadav, Pavan Pradhan
Format: Article
Language:English
Published: Elsevier 2025-04-01
Series:Journal of Orthopaedic Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2773157X25000104
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author Navin Kumar Yadav
Pavan Pradhan
author_facet Navin Kumar Yadav
Pavan Pradhan
author_sort Navin Kumar Yadav
collection DOAJ
description Background: Scaphoid fracture nonunion may be considered a serious problem if not treated properly. Nonunion can lead to resorption, loss of bone, and deformity. Iliac bone graft with double Kirschner wire (K-wire) fixation is an effective way to establish scaphoid union. This study aims to assess the clinical and radiological outcomes of an iliac crest bone graft with double K-wire fixation for the treatment of scaphoid nonunion. Methods: Twenty-two cases treated with iliac crest bone graft and double K-wire fixation for nonunion scaphoid fracture were included in this study. The average follow-up duration was 15 ± 3 months. Visual analog scale (VAS), grip strength, range of motion (ROM), and modified Mayo wrist score were compared with the opposite side. Post-operative radiographs were compared to preoperative images to ascertain the union. Results: Twenty (90.9 %) cases achieved bony union. Postoperative improvement revealed statistical significance (p-value <0.05) for all criteria of the modified Mayo wrist score. At the final follow-up, twelve patients (54.5 %) had excellent results; eight patients (36.4 %) had good results, and two patient (9.1 %) had fair results. Following surgery, the mean scapholunate and radio scaphoid angles have been within normal limits on the radiographs. Conclusion: Using an iliac bone graft with double K-wire fixation is an efficacious and reliable method to treat scaphoid nonunion. Thus, this procedure is a feasible surgical alternative for the scaphoid fracture nonunion.
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spelling doaj-art-27fe476a8e7c4275977ee06efd20c7722025-08-20T02:07:23ZengElsevierJournal of Orthopaedic Reports2773-157X2025-04-014110055810.1016/j.jorep.2025.100558Treatment of scaphoid waist nonunion with iliac crest bone graft and double Kirschner wire fixation: An observational clinical studyNavin Kumar Yadav0Pavan Pradhan1Department of Orthopaedics, Baba Raghav Das Medical College, Gorakhpur, India; Corresponding author.Department of Orthopaedics Baba Raghav Das Medical College, Gorakhpur, IndiaBackground: Scaphoid fracture nonunion may be considered a serious problem if not treated properly. Nonunion can lead to resorption, loss of bone, and deformity. Iliac bone graft with double Kirschner wire (K-wire) fixation is an effective way to establish scaphoid union. This study aims to assess the clinical and radiological outcomes of an iliac crest bone graft with double K-wire fixation for the treatment of scaphoid nonunion. Methods: Twenty-two cases treated with iliac crest bone graft and double K-wire fixation for nonunion scaphoid fracture were included in this study. The average follow-up duration was 15 ± 3 months. Visual analog scale (VAS), grip strength, range of motion (ROM), and modified Mayo wrist score were compared with the opposite side. Post-operative radiographs were compared to preoperative images to ascertain the union. Results: Twenty (90.9 %) cases achieved bony union. Postoperative improvement revealed statistical significance (p-value <0.05) for all criteria of the modified Mayo wrist score. At the final follow-up, twelve patients (54.5 %) had excellent results; eight patients (36.4 %) had good results, and two patient (9.1 %) had fair results. Following surgery, the mean scapholunate and radio scaphoid angles have been within normal limits on the radiographs. Conclusion: Using an iliac bone graft with double K-wire fixation is an efficacious and reliable method to treat scaphoid nonunion. Thus, this procedure is a feasible surgical alternative for the scaphoid fracture nonunion.http://www.sciencedirect.com/science/article/pii/S2773157X25000104Kirschner wireIliac crestBone graftScaphoidNonunion
spellingShingle Navin Kumar Yadav
Pavan Pradhan
Treatment of scaphoid waist nonunion with iliac crest bone graft and double Kirschner wire fixation: An observational clinical study
Journal of Orthopaedic Reports
Kirschner wire
Iliac crest
Bone graft
Scaphoid
Nonunion
title Treatment of scaphoid waist nonunion with iliac crest bone graft and double Kirschner wire fixation: An observational clinical study
title_full Treatment of scaphoid waist nonunion with iliac crest bone graft and double Kirschner wire fixation: An observational clinical study
title_fullStr Treatment of scaphoid waist nonunion with iliac crest bone graft and double Kirschner wire fixation: An observational clinical study
title_full_unstemmed Treatment of scaphoid waist nonunion with iliac crest bone graft and double Kirschner wire fixation: An observational clinical study
title_short Treatment of scaphoid waist nonunion with iliac crest bone graft and double Kirschner wire fixation: An observational clinical study
title_sort treatment of scaphoid waist nonunion with iliac crest bone graft and double kirschner wire fixation an observational clinical study
topic Kirschner wire
Iliac crest
Bone graft
Scaphoid
Nonunion
url http://www.sciencedirect.com/science/article/pii/S2773157X25000104
work_keys_str_mv AT navinkumaryadav treatmentofscaphoidwaistnonunionwithiliaccrestbonegraftanddoublekirschnerwirefixationanobservationalclinicalstudy
AT pavanpradhan treatmentofscaphoidwaistnonunionwithiliaccrestbonegraftanddoublekirschnerwirefixationanobservationalclinicalstudy