This 2012 current-concepts review by Buijze, Ochtman, and Ring surveys the diagnosis and surgical management of scaphoid nonunion — covering risk factors, imaging strategies, the spectrum of bone grafting options, pediatric considerations, and salvage procedures — without reporting original patient data.
When you assess an acute scaphoid fracture, displacement on plain film is unreliable — CT is the standard to rule out instability, since missed displacement drives the bulk of preventable nonunions.
Once nonunion is established, CT characterizes deformity and flags proximal pole sclerosis (rules in AVN if present), while the choice between nonvascularized and vascularized grafting should be guided by AVN status and surgeon experience rather than assumed superiority of vascularized techniques.
This 2012 current-concepts review by Buijze, Ochtman, and Ring surveys the diagnosis and surgical management of scaphoid nonunion — covering risk factors, imaging strategies, the spectrum of bone grafting options, pediatric considerations, and salvage procedures — without reporting original patient data.
When you assess an acute scaphoid fracture, displacement on plain film is unreliable — CT is the standard to rule out instability, since missed displacement drives the bulk of preventable nonunions.
Once nonunion is established, CT characterizes deformity and flags proximal pole sclerosis (rules in AVN if present), while the choice between nonvascularized and vascularized grafting should be guided by AVN status and surgeon experience rather than assumed superiority of vascularized techniques.