Arthroscopic-Assisted Debridement and Bone Grafting for Scaphoid Nonunion

Description

This presentation by Christine Schaeffer, a hand and upper extremity fellow at Emory University, discusses an arthroscopic approach to manage a case of scaphoid delayed union in a 15-year-old male football player. After sustaining a wrist injury during a fistfight, the patient experienced persistent pain and reduced range of motion, leading to a diagnosis of scaphoid waist delayed union confirmed through imaging techniques. The presentation highlights the surgical intervention's necessity given the high risk of nonunion with continued non-operative management. It outlines the surgical options available, emphasizing the use of arthroscopic debridement and internal fixation, while mentioning contraindications such as carpal collapse and severe arthritis. The surgical technique is detailed, including the preparation of the nonunion site using arthroscopic tools and the application of a bone graft harvested from the distal radius. Post-operative results indicate excellent outcomes with no pain and successful bony bridging observed in follow-up X-rays. Schaeffer summarizes the advantages of arthroscopic methods, particularly in maintaining vascularity of the scaphoid and the promising union rates from recent studies.

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