Patients with scaphoid nonunion with humpback deformity and collapse of the wrist were treated with palmar wedge bone grafting combined with reduction of the lunate to correct the dorsal intercalated segment instability deformity. Union was obtained at an average of 3 months, and patient satisfaction with functional outcome and pain relief was high. Palmar wedge bone grafting combined with correction of lunate malalignment successfully achieved scaphoid union, restored scaphoid length, and avoided the potential complication of scaphoid malunion. This report revisits a technique that facilitates accurate correction of lunate malalignment (dorsal intercalated segment instability) by initial reduction and pin fixation to the radius before insertion of scaphoid bone graft and internal fixation. (J Hand Surg 2000;25A:322–329. Copyright © 2000 by the American Society for Surgery of the Hand.)
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Accepted: November 2, 1999
Received: April 13, 1999
*No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
**Reprint requests: Matthew M. Tomaino, MD, 3471 Fifth Ave, Suite 1010, Pittsburgh, PA 15213.
**J Hand Surg 2000;25A 322–329
© 2000 Published by Elsevier Inc.