The role of surgical timing in 124 scaphoid nonunion surgical procedures

IF 0.9 4区医学 Q4 ORTHOPEDICS

Hand Surgery & Rehabilitation Pub Date : 2025-04-01 DOI:10.1016/j.hansur.2025.102114

Géraldine Lautenbach , Andreas Schweizer , Tobias Götschi , Raffael Labèr

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Abstract

A total of 124 scaphoid nonunion surgical procedures performed between 2002 and 2020 were analyzed to investigate the potential impact of delayed diagnosis on time to union. The primary outcome was the correlation between the time from injury to surgery and the time to union. Secondary outcomes included identifying risk factors for delayed union and persistent nonunion following scaphoid nonunion surgery.

The analysis revealed that time to union was similar for surgeries performed between 6 months and over 2 years post-injury. However, nonunion persisted in 12 cases, five of which involved surgeries conducted more than 2 years after the injury. Further investigation into secondary outcomes showed that fractures in the proximal third of the scaphoid took 1.4–1.5 times longer to unite compared to fractures in the middle and distal thirds. Additionally, fractures without trabecular bone required approximately twice as long to heal.

In conclusion, surgical intervention performed between 6 months and over 2 years after injury generally offers a favorable outcome for healing. However, when surgery is delayed beyond 2 years, the risk of persistent nonunion increases.

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124例舟状骨不连手术中手术时机的作用。

本研究分析了2002年至2020年间进行的124例舟状骨不愈合手术，以调查延迟诊断对愈合时间的潜在影响。主要观察结果是损伤至手术时间与愈合时间之间的相关性。次要结局包括确定舟状骨不愈合手术后延迟愈合和持续性不愈合的危险因素。分析显示，损伤后6个月至2年以上的手术愈合时间相似。然而，12例不愈合持续存在，其中5例在受伤后2年多进行手术。对次要结果的进一步研究表明，舟状骨近三分之一骨折愈合时间是中、远三分之一骨折愈合时间的1.4 - 1.5倍。此外，没有骨小梁愈合的骨折需要大约两倍的时间才能愈合。总之，在损伤后6个月至2年以上的时间内进行手术干预通常可以提供良好的愈合结果。然而，当手术延迟超过2年，持续性骨不连的风险显著增加。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hand Surgery & Rehabilitation Medicine-Surgery

CiteScore

1.70

自引率

27.30%

发文量

审稿时长

49 days

期刊介绍： As the official publication of the French, Belgian and Swiss Societies for Surgery of the Hand, as well as of the French Society of Rehabilitation of the Hand & Upper Limb, ''Hand Surgery and Rehabilitation'' - formerly named "Chirurgie de la Main" - publishes original articles, literature reviews, technical notes, and clinical cases. It is indexed in the main international databases (including Medline). Initially a platform for French-speaking hand surgeons, the journal will now publish its articles in English to disseminate its author''s scientific findings more widely. The journal also includes a biannual supplement in French, the monograph of the French Society for Surgery of the Hand, where comprehensive reviews in the fields of hand, peripheral nerve and upper limb surgery are presented. Organe officiel de la Société française de chirurgie de la main, de la Société française de Rééducation de la main (SFRM-GEMMSOR), de la Société suisse de chirurgie de la main et du Belgian Hand Group, indexée dans les grandes bases de données internationales (Medline, Embase, Pascal, Scopus), Hand Surgery and Rehabilitation - anciennement titrée Chirurgie de la main - publie des articles originaux, des revues de la littérature, des notes techniques, des cas clinique. Initialement plateforme d''expression francophone de la spécialité, la revue s''oriente désormais vers l''anglais pour devenir une référence scientifique et de formation de la spécialité en France et en Europe. Avec 6 publications en anglais par an, la revue comprend également un supplément biannuel, la monographie du GEM, où sont présentées en français, des mises au point complètes dans les domaines de la chirurgie de la main, des nerfs périphériques et du membre supérieur.