Arthroscopic Scaphoid Grafting Versus Open Grafting in Scaphoid Non Union

N/ACompletedNCT07320404

Ain Shams University30 enrolled

Overview

the investigators compare the arthroscopic grafting technique with the traditional open technique in th treatment of scaphoid non union as regards the union rate, time to union and functional outcomes to provide the best intervention to the patient

The treatment of scaphoid non union has no gold standard technique so in this study the investigators try to compare the arthroscopic and the open grafting techniques to determine the better technique to achieve union, time to union and the better functional outcomes including wrist range of motion and grip strength as a primary outcome and the secondary outcomes are the operative time, the complications and radiological correction of the hum-back deformity if present.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

QUADRUPLE

Enrollment

Conditions

Scaphoid Fracture Non Union

Interventions

Arthroscopic grafting and k wires fixationPROCEDURE

Arthroscopic midrcarpal scaphoid non union debridment and iliac cancellous bone grafting with K wires fixation

open scaphoid grafting with K wires fixationPROCEDURE

open surgical volar or dorsal scaphoid non union site debridment and application of iliac bone graft and K wires fixation

Eligibility

Sex: ALLMin age: 16 Years

Medical Language ↔ Plain English

Inclusion Criteria: * scaphoid non-union cases * 16 years or older * males or females * independent from chronicity or non-union location and the investigators defined the non union as failure to reach scaphoid union up to 6 months Exclusion Criteria: .Revision scaphoid non-union cases. * Previously operated wrist for any other pathology * Avascular necrosis (AVN) confirmed by intraoperative inspection. * Scaphoid non-union advanced collapse (SNAC) stage 2 and higher. * Any associated wrist pathology that required separate treatment surgical approach.

Locations (1)

Faculty of medicine, Ain Shams University

Cairo, Egypt

Outcomes

Primary Outcomes

union rate

percentage of patients in each arm that achieve bony union

Time frame: 6 months

time to union

the time that patient take to achieve bony union

Time frame: 6 to 24 weeks

wrist flexion and extension

flexion and extension range of motion

Time frame: preoperative, at 6 months and at 24 months

wrist radial and ulnar deviation

radial and ulnar deviation range of motion

Time frame: preoperative, at 6 months and at 24 months

grip strength

the power of hand grip measured by dynamometer

Time frame: preoperative , at 6 months and at 24 months

The disability of arm, shoulder and hand score (DASH score)

a questionnaire to assess upper limb function from 0 to 100 where the lower the score means better outcome

Time frame: preoperative , at 6 months and at 24 months

The Mayo modified wrist score

A functional score that depends on the patients function and examination from 0 to 100 and the higher the score the higher the outcome

Time frame: preoperative, at 6 months and at 24 months

Secondary Outcomes

complications

Time frame: 2 years post operative

Degree of scaphoid hump back deformity correction

Data from ClinicalTrials.gov

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