Treatment of scaphoid waist nonunion with iliac crest bone graft and double Kirschner wire fixation: An observational clinical study

Scaphoid fracture nonunion may be considered a serious problem if not treated properly. Nonunion can lead to resorption, loss of bone, and deformity. Iliac bone graft with double Kirschner wire (K-wire) fixation is an effective way to establish scaphoid union. This study aims to assess the clinical and radiological outcomes of an iliac crest bone graft with double K-wire fixation for the treatment of scaphoid nonunion. Twenty-two cases treated with iliac crest bone graft and double K-wire fixation for nonunion scaphoid fracture were included in this study. The average follow-up duration was 15 ± 3 months. Visual analog scale (VAS), grip strength, range of motion (ROM), and modified Mayo wrist score were compared with the opposite side. Post-operative radiographs were compared to preoperative images to ascertain the union. Twenty (90.9 %) cases achieved bony union. Postoperative improvement revealed statistical significance (p-value <0.05) for all criteria of the modified Mayo wrist score. At the final follow-up, twelve patients (54.5 %) had excellent results; eight patients (36.4 %) had good results, and two patient (9.1 %) had fair results. Following surgery, the mean scapholunate and radio scaphoid angles have been within normal limits on the radiographs. Using an iliac bone graft with double K-wire fixation is an efficacious and reliable method to treat scaphoid nonunion. Thus, this procedure is a feasible surgical alternative for the scaphoid fracture nonunion.