Abstract
Background:
The objective of the study is to characterize factors associated with radiographic union and pain at final follow-up in surgical repair of scaphoid nonunion.
Methods:
Patients who underwent scaphoid nonunion repair at our institution between 2005 and 2024 were retrospectively reviewed. Demographic and surgical factors were abstracted. Preoperative, immediate postoperative, and final follow-up scapholunate (SL) angles were measured. Radiographic union (>75% healing) and patient-reported pain at final follow-up were assessed. Associations between SL angle measurements, patient characteristics, and surgical variables with union and pain were evaluated using unpaired t tests and χ2 tests.
Results:
Fifty-five patients met inclusion criteria with persistent nonunion occurring in 17 patients (30.1%). Patient sex was significantly associated with union (P = .045) but not pain at final follow-up (P = .399). All other demographic factors (smoking status, diabetes, prior surgery) and surgical factors (fracture location, surgical approach, implant type, graft type, and use of adjunct Kirschner-wire) were not significantly associated with union or pain at final follow-up (all P > .05). Among SL angle measurements, only a lower final follow-up SL angle was significantly associated with higher union rates (P = .038). No SL angle measurement was associated with pain at follow-up (all P > .05).
Conclusions:
Patient sex was associated with union. No other demographic or surgical variables were associated with union or pain at final follow-up. A lower SL angle at final follow-up was independently associated with successful union, suggesting that correction of carpal alignment may contribute to improved healing in scaphoid nonunion repair.
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