Volar scaphoid plating for nonunion: a multicenter case series study

Eng, Kevin, Gill, Stephen, Hoy, Simon, Shridar, Vivek, Van Zyl, Natasha and Page, Richard 2020, Volar scaphoid plating for nonunion: a multicenter case series study, Journal of wrist surgery, vol. 9, no. 3, pp. 225-229, doi: 10.1055/s-0040-1702199.


Title Volar scaphoid plating for nonunion: a multicenter case series study
Author(s) Eng, Kevin
Gill, StephenORCID iD for Gill, Stephen orcid.org/0000-0001-8722-0572
Hoy, Simon
Shridar, Vivek
Van Zyl, Natasha
Page, RichardORCID iD for Page, Richard orcid.org/0000-0002-2225-7144
Journal name Journal of wrist surgery
Volume number 9
Issue number 3
Start page 225
End page 229
Total pages 5
Publisher Thieme Publishers
Place of publication New York, N.Y.
Publication date 2020-03
ISSN 2163-3916
2163-3924
Keyword(s) Science & Technology
Life Sciences & Biomedicine
Orthopedics
scaphoid
nonunion
plate fixation
bone grafting
Summary Background The volar scaphoid plate from Medartis (Medartis AG, Austrasse, Basel, Switzerland) is a variable angle titanium locking plate, preformed for the volar aspect of the scaphoid. It does not have compressive capability, and may act as a bridging device. It may provide an advantage over a compression screw where the pathoanatomy is less favorable to such a device with increased rotational stability. It may act as a buttress plate for correction of humpback deformity for example. It has been used in nonunions and with vascularized grafts. Questions Our study aims to assess the results of our patients with scaphoid nonunion treated with scaphoid volar plating over a larger number of patients. We aim to identify techniques to increase the success of plating. Methods Patients from our cohort were retrospectively reviewed. Operations were performed by three hand fellowship trained surgeons and in two centers. Inclusion involved a scaphoid plate procedure for a nonunion of the scaphoid with a minimum of 6 months of follow-up. Exclusions were those who had less than 6 months of follow-up. Data included demographics, patient-rated wrist evaluation (PRWE), a quick disabilities of the arm, shoulder, and hand (qDASH), visual analogue score, and range and grip. Radiology was reviewed. Results Thirty-two eligible patients were assessed. The mean age was 25 years (range 13–46), 2 were female and 15 were smokers. Mean follow-up postsurgery was 18 months. Twenty-nine of 32 patients united (90.6%) on computed tomography scan. Clinical assessment was performed in the 25 patients. The mean qDASH score was 12.5 (range 0–42) and mean PRWE was 11 (range 0–54). The mean arc of motion was 115 degrees. The mean grip strength was 39 kg compared with 41 kg on the nonoperated side. Conclusion We postulate that the plate acts like an internal bridging device, acting over a small distance, and inherent stability of the construct with structural graft and accurate reduction prior to plating is advantageous. Potential problems include plate impingement on the volar lip of the radius, particularly when trying to plate more proximal fractures. Ideally, it is utilized for mid to distal waist fractures.
Language eng
DOI 10.1055/s-0040-1702199
Indigenous content off
HERDC Research category C1 Refereed article in a scholarly journal
Persistent URL http://hdl.handle.net/10536/DRO/DU:30135569

Document type: Journal Article
Collections: Faculty of Health
School of Medicine
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