Management of Scaphoid Nonunion With Iliac Crest Graft and K-wire Fixation: An Economically Viable Option

Purpose This study details the functional results, patient satisfaction, and cost-effectiveness of patients treated with Fisk-Fernandez surgery using iliac crest graft and K-wire for scaphoid nonunion. Materials and methods This study involved a retrospective analysis conducted between November 2022 and August 2024. Forty-two patients diagnosed with scaphoid nonunion were treated using a surgical approach that included autologous bone grafting combined with K-wire fixation to promote bone healing and stability. To enable comparison, the QuickDASH-9 score, visual analog scale (VAS), and patient-rated wrist evaluation (PRWE) score were used for both preoperative and postoperative evaluations at the final follow-up. Results Our study group received treatment for an average of 16 months post-injury, ranging from 6 to 28 months. The average time of union was six months, ranging from four to 18 months. The study significantly improved QuickDASH-9 scores, grip strength, PRWE scores, and VAS for pain. The study reported no complications, and all patients returned to their basic activities of daily living. Conclusion Results of this study show that displaced scaphoid nonunions can be successfully treated with K-wire fixation combined with iliac crest bone grafting utilizing the Fisk-Fernandez approach.