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01 February 2011

A modified matti-russe technique for the treatment of scaphoid waist non-union and pseudarthrosis

Aristidis B. ZoubosADE, Ioannis K. TriantafyllopoulosABCDEF, George C. BabisADE, Panayiotis N. SoucacosADE

DOI: 10.12659/MSM.881376

Med Sci Monit 2011; 17(2): MT7-12

Abstract

Background: The aim of this study was to analyze the long-term results of a modified Matti-Russe technique for the treatment of scaphoid non-union and pseudarthrosis. The modification was based on the use of bone graft taken from the ipsilateral distal radius, rather than from the iliac crest, as originally described.
Material/Methods: Between 1987 and 2000, 23 consequent male patients with scaphoid waist non-union or pseudarthrosis underwent surgery by a modified Matti-Russe technique. During the 5-year follow-up, patient evaluation was based on radiological findings and the Green and O’Brien scoring system.
Results: Anatomy was restored and healing of the non-union was achieved in 21 (91.3%) patients. The other 2 patients failed to achieve union and underwent the same operation a second time, which was successful. According to the Green and O’Brien scoring system, 82.6% (19/23) of patients showed excellent results and 17.4% (4/23) showed good results at 2-year follow-up. At 5-year follow-up, 73.9% of patients (19/23) had excellent results and 26.0% (4/23) had good results. No early post-operative complications developed. Two patients demonstrated mild radiological radio-scaphoid arthritis at 2.5 years postoperatively. All patients returned to previous levels of activity.
Conclusions: The standard Matti-Russe technique is an old but reliable and inexpensive method for the treatment of long-standing or neglected scaphoid non-unions or pseudarthroses. The modification of this established method, based on use of the distal radius as a donor site, reduces operative time, can be performed through a single approach, does not show donor site morbidity, and allows the use of regional anaesthesia.

Keywords: Scaphoid Bone - surgery, Pseudarthrosis - surgery, Follow-Up Studies, Bone Transplantation - methods, Adolescent, Wrist Joint - surgery, young adult

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Medical Science Monitor eISSN: 1643-3750