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CASE REPORT
Management of a 15-year-old scaphoid non-union
  1. Kai Yuen Wong1,
  2. Olivia Sharp2,
  3. Phillip Johnston3
  1. 1Department of Plastic Surgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
  2. 2Department of Plastic Surgery, Salisbury NHS Foundation Trust, Salisbury, UK
  3. 3Department of Trauma and Orthopaedic Surgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
  1. Correspondence to Mr Kai Yuen Wong, kaiyuen.wong{at}cantab.net

Summary

Scaphoid non-union affects wrist joint function and is often associated with a predictable pattern of degenerative change. A 30-year-old man presented with a symptomatic 15-year-old right scaphoid fracture with secondary scaphoid non-union advanced collapse of his right wrist. There was no evidence of avascular necrosis. The initial injury was from a fall onto his outstretched hand. We performed a right scaphoid open reduction, internal fixation and iliac crest bone graft. One year after the operation, the patient had good wrist function and grip strength. A CT scan showed union of the fracture. Studies have shown that if the time between initial fracture and treatment of non-union exceeds 5 years, the chances of healing of the non-union are markedly reduced. In our case, despite the long duration between timing of injury and surgery, there was union and good return of function.

  • orthopaedics
  • surgery
  • orthopaedic and trauma surgery
  • plastic and reconstructive surgery

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Footnotes

  • KYW and OS contributed equally.

  • Contributors KYW and OS contributed equally to this work. All authors, including PJ, contributed significantly to the drafting, review and approval of the manuscript.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.