Results

Follow up

None of the patients were lost to follow-up. Mean follow up in our study was 25.5 months (14—55
months). All the patients achieved bony consolidation after an average of 9.8 weeks (range 6 to 12
weeks). The radiologic criterion of bony consolidation included: disappearance of fracture line, bridging
bone trabeculae and restoration of normal bone density. 11 patients were completely pain free and 2
complained of slight pain with strenuous activities.

Bony union

Solid bony union was observed in 10 of the 13 patients. In 7 of these 10 patients bony union was
determined by plain x-rays and clinical examination. No persistent gap, screw loosening, or fracture
displacement was observed in any of these patients and trabeculae were seen crossing the nonunion
site (in all 3 views in 5 patients and in 2 views in 2 patients). In 3 of the 10 patients a CT scan was used to
show bone union. The mean time to union was 13 weeks (range, 6–23 wk). Solid union was observed in
8 of the 10 patients who were diagnosed with avascular necrosis of the proximal pole of the scaphoid.

Pain

Eight of the patients with solid bone union were completely pain free and 2 complained of slight pain
with strenuous activities.

Range of motion

1. The mean flexion was 45° (range, 30°–80°) compared with a mean of 32° before surgery.
2. The mean extension was 68° (range, 30°–90°; preoperative mean, 44°).
3. Ulnar deviation averaged 21° (range, 10°–35°; preoperative mean, 12°) and
4. radial deviation averaged 15° (range, 10°–25°; preoperative mean, 9°).
5. Pronation and supination were noted to be full in all patients.
6. The mean grip strength was 81% (range, 65%–105%) compared with that of the contralateral
healthy extremity, which had improved from a preoperative mean of 64%.
7. Range of motion was improved significantly in the flexion (p .05) and extension (p .01) arcs
compared with preoperative values.
8. Improvement of grip strength also was statistically significant (p .01).

In the range of motion assessment,

 the mean wrist flexion at the
affected side was 68° and the non-
affected side 75° (range 49°
to 75°).
 The mean extension was 63° on the
affected side and 72° of the non-affected
 side (ranging from 47° to 69°).
 The mean grip strength was 35 kgf,
corresponding to 98% of the nonaffected
hand (37 kgf, ranging from 33 kgf to 38
kgf).

Complication

There were no early complications as pintrack infection, sensory disturbances in the area
of the radial nerve, hematomas or problems
with the healing of the wound. There were also
none late septic complications.

1. Persistent Nonunion
2. stiffness requiring tenoarthrolysis
3. complex regional pain syndrome
4. arthritis of
5. arthritis at graft site
6. No complications other than the 3 persistent nonunions or donor site morbidity were observed

Subjective and functional results

Return to function

Seven of the 11 patients who were employed before their injuries returned to their occupations. Two
more returned to lighter-duty work and 2 were unemployed

All the patients have been able to return to their former activities with no pain