total scaphoid titanium arthroplasty: A 15-year experience

Carpus


The total scaphoid titanium arthroplasty: A 15-year experience


Spingardi O, Rossello MI (Ospedale San Paolo, Savona, Italy) Hand 6:179-184, 2011§



J. Frankenhoff, MD



Evidence Ranking


• B



Expert Rating


• 1



Abstract


Scaphoid nonunion followed by necrosis of bone segments is a common pathologic condition for the hand surgeon, and the difficulty of its management is well known. The total titanium scaphoid replacement, although not well-described in the literature, in our experience represents a reasonable choice in the treatment of this condition. Strict patient selection is necessary to achieve good clinical results. The titanium avoids the silicone synovitis, a well-described complication of silastic implants. Furthermore, this technique permits other surgical steps in case of failure (Table 1).



Table 1 The Clinical Findings

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Commentary


One of the authors of this study (O.S.) was on the development team for Wright’s titanium scaphoid implant and has since used it exclusively for select scaphoid nonunions. This article summarizes that 15-year experience. During that time, he placed 113 implants, but had a follow-up of more than 6   months (mean follow-up of 46   months) for only 75 patients (66%).


Patients chosen did not have arthritis or any signs of carpal collapse. Of note, the patients had failed prior conservative or surgical management of their scaphoid nonunions, including Matti-Russe grafting, screw fixation, or vascularized bone grafting.

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Apr 2, 2016 | Posted by in Hand surgery | Comments Off on total scaphoid titanium arthroplasty: A 15-year experience

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