Treatment Of Scaphoid Nonunion With Russe Technique

Objective:We describe the operative technique of treatment with Russe technique in patients with scaphoid nonunion.The purpose of this study was to report the functional and radiographic outcome and estimate the effect of this treatment.Methods:From 2003 to 2008,10 pationts with scaphoid nonunion were treated with Russe technique. There were 8 male and 2 female patients, with an average age of 27.7 years (range, 18?47). The average time from injury to surgery was 8.6 months (range, 6-16months). The dominant hand was involved in 6 cases. 2 patients had proximal pole fractures, 2 patients had distal pole fractures and 6 patients had scaphoid waist fractures. The dorsoradial incision was adopted.A 13mm*5mm*5mm bone trough between the proximal and the distal fragments was tailored.A bone graft corresponding in size to the trough was harvested from the dosal distal radius and transposed to the recipient scaphoid site.The extremity was immobilized postoperatly in the below-the-elbow thumb spica cast.Outcomes were assessed by x-ray and the modified Mayo wrist score system.Results:All the 10 patients had pain relief after surgery with an average follow-up of 13 months(range,6-20months).7 patients were totally free of pain.3 patients stated slight to moderate pain at exercise. The mean percentage of grip strength to normal was 90%.Range of motion: As a mean,dorsal extension was 72.5°;volar flexion was 69.5°.Osseous union was achieved in all patients.The union time averaged 3.4 months.Outcomes were assessed by the modified Mayo wrist score system(four excellent, four good, and two fair).Conclusions:Our study suggested thar the Russe technique was simple to manipulate and was effiction for treating scaphoid nonunion.The post operate union rate was encouraging.The dorsoradial incision could sufficiengly expose the scaphoid nonunion site and distal radius and make it easy for surgeons to harvest and plant the bone graft.