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Pedicled vascularized bone graft
32%
33/102
Long arm thumb spica cast
0%
0/102
Percutaneous screw fixation
9%
9/102
Corticocancellous bone grating via a volar approach (Matti-Russe)
27%
28/102
Open reduction and differential pitch screw placement via a dorsal approach
31%
32/102
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The patient has a nonunion of the proximal pole of the scaphoid. Acutely, this can be repaired with a screw alone, but as a nonunion the proximal pole has very poor healing potential. Vacularized bone grafts have been successful for these challenging nonunions, particularly in adolescents. A cast can be used for nondisplaced acute waist fractures, and corticocancellous grafts can be used for nonunions of the waist.
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