Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
the investigators compare the arthroscopic grafting technique with the traditional open technique in th treatment of scaphoid non union as regards the union rate, time to union and functional outcomes to provide the best intervention to the patient
The treatment of scaphoid non union has no gold standard technique so in this study the investigators try to compare the arthroscopic and the open grafting techniques to determine the better technique to achieve union, time to union and the better functional outcomes including wrist range of motion and grip strength as a primary outcome and the secondary outcomes are the operative time, the complications and radiological correction of the hum-back deformity if present.
Not provided
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| arthroscopic A group | Experimental | arthroscopic bone grafting combined with percutaneous K wires fixation for scaphoid non union patients |
|
| open O group | Experimental | open volar or dorsal scaphoid grafting with K wires fixation for scaphoid non union patients |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Arthroscopic grafting and k wires fixation | Procedure | Arthroscopic midrcarpal scaphoid non union debridment and iliac cancellous bone grafting with K wires fixation |
|
| Measure | Description | Time Frame |
|---|---|---|
| union rate | percentage of patients in each arm that achieve bony union | 6 months |
| time to union | the time that patient take to achieve bony union | 6 to 24 weeks |
| wrist flexion and extension | flexion and extension range of motion | preoperative, at 6 months and at 24 months |
| wrist radial and ulnar deviation | radial and ulnar deviation range of motion | preoperative, at 6 months and at 24 months |
| grip strength | the power of hand grip measured by dynamometer | preoperative , at 6 months and at 24 months |
| The disability of arm, shoulder and hand score (DASH score) | a questionnaire to assess upper limb function from 0 to 100 where the lower the score means better outcome | preoperative , at 6 months and at 24 months |
| The Mayo modified wrist score | A functional score that depends on the patients function and examination from 0 to 100 and the higher the score the higher the outcome | preoperative, at 6 months and at 24 months |
| Measure | Description | Time Frame |
|---|---|---|
| complications | 2 years post operative | |
| Degree of scaphoid hump back deformity correction | Radiological parameter thorough scapholunate angle | post operative after bony union up to 1 year |
Not provided
Inclusion Criteria:
Exclusion Criteria:
.Revision scaphoid non-union cases.
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Affiliation | Role |
|---|---|---|
| Mohammed El-Mahy, prof. | Ain Shams University | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Faculty of medicine, Ain Shams University | Cairo | 11591 | Egypt |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 26051763 | Background | Jegal M, Kim JS, Kim JP. Arthroscopic Management of Scaphoid Nonunions. Hand Surg. 2015;20(2):215-21. doi: 10.1142/S0218810415400031. | |
| 15513497 | Result | Munk B, Larsen CF. Bone grafting the scaphoid nonunion: a systematic review of 147 publications including 5,246 cases of scaphoid nonunion. Acta Orthop Scand. 2004 Oct;75(5):618-29. doi: 10.1080/00016470410001529. |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
2 groups one with the arthroscopic grafting combined with percutaneous fixation, the second with opend grafting and fixation by K wires.
Not provided
Not provided
Not provided
| open scaphoid grafting with K wires fixation | Procedure | open surgical volar or dorsal scaphoid non union site debridment and application of iliac bone graft and K wires fixation |
|
| Operative time | the duration of each operation | intraoperative |