A Comparative Study on the Treatment of Scaphoid Nonunion with Matti-Russe Technique and Fisk-Fernandez Technique

Seung Hwan Rhee; Moon Sang Chung; Young Ho Lee; Hyun Sik Gong; Ji Yeong Kim; Jeong Hwan Kim; Goo Hyun Baek

doi:10.4055/jkoa.2008.43.6.694

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Rhee, Chung, Lee, Gong, Kim, Kim, and Baek: A Comparative Study on the Treatment of Scaphoid Nonunion with Matti-Russe Technique and Fisk-Fernandez Technique

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2008; 43(6): 694-702.

Published online: 31 December 2008

DOI: https://doi.org/10.4055/jkoa.2008.43.6.694

A Comparative Study on the Treatment of Scaphoid Nonunion with Matti-Russe Technique and Fisk-Fernandez Technique

Seung Hwan Rhee, M.D., Moon Sang Chung, M.D., Young Ho Lee, M.D., Hyun Sik Gong, M.D., Ji Yeong Kim, M.D., Jeong Hwan Kim, M.D., Goo Hyun Baek, M.D.

Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea.

Address reprint requests to Goo Hyun Baek, M.D. Department of Orthopedic Surgery, Seoul National University College of Medicine, 28, Yongon-dong, Chongno-gu, Seoul 110-744, Korea. Tel: +82.2-2072-3787, Fax: +82.2-764-2718, ghbaek@snu.ac.kr

Abstract

Purpose

Established scaphoid nonunion may lead to carpal instability and osteoarthritis. The purpose of this study is to compare the clinical and radiological results of the osteosynthesis between Matti-Russe group and Fisk-Fernandez group.

Materials and Methods

Our retrospective study included 21 nonunion cases in 20 patients treated by Matti-Russe or Fisk-Fernandez technique from September 2001 to August 2006. The mean duration of follow up was 31 months. Based on the questionnaire which included clinical information and the radiologic evaluation, we compared the objective and subjective results between two surgical groups.

Results

There were no significant differences between two groups in respect of the postoperative satisfaction and the pain. Both the range of motion and the grip power decreased compared to that of the unaffected side, but there were no significant differences between two groups. Also, there were no significant differences in the union rate and the rate of successful correction of DISI deformity. In all cases in which DISI deformity was detected preoperatively, the deformity was corrected postoperatively. There were 7 cases of osteoarthritis, but among them only one case appeared newly after the surgery.

Conclusion

There were no significant differences between two surgical groups in clinical and radiological results. Both techniques were effective in achieving bony union and functional recovery.

Keywords: Scaphoid Nonunion, Matti-Russe, Fisk-Fernandez

Figures and Tables

Fig. 1

Comparison of postoperative pain between two groups. There was no significant difference in pain statistically (p=0.940).

Fig. 2

Comparison of postoperative satisfaction between two groups. There was no significant difference in satisfaction statistically (p=0.671).

Fig. 3

Osteosynthesis using Matti-Russe technique. (A, B) Preoperative plain radiograph showed cyctic change around nonunion site and sclerotic change in proximal fragment. (C) Low signal intensity in proximal fragment in T1-weighted MRI image suggested osteonecrosis. (D, E) There are multiple Kirschner wires used for internal fixation of scaphoid in immediately postoperative plain radiograph. (F, G) After 1 year and 8 months from the operation, the bony union was solid and the alignment was well maintained.

Fig. 4

Osteosynthesis using Fisk-Fernandez technique. (A, B) Preoperative plain radiograph showed sclerotic change around nonunion site. (C) The sagittal MRI image showed advanced humpback deformity. (D, E) Humpback deformity was corrected in immediately postoperative plain radiograph. (F, G) At final, the bony union was solid and the alignment was well maintained.

Table 1

Demographic Features and Preoperative Radiologic Evaluation

Table 2

Postoperative Results - Clinical and Radiological Evaluation

^*DF, dorsiflexion; VF, volar flexion; Rd, radial deviation; Ud, ulnar deviation.

Table 3

Summary of the Previous Studies of Conventional Osteosynthesis

^*DF, dorsiflexion; VF, volar flexion; Rd, radial deviation; Ud, ulnar deviation.

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