{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T19:28:56Z","timestamp":1770233336613,"version":"3.49.0"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2023,2,20]],"date-time":"2023-02-20T00:00:00Z","timestamp":1676851200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,2,20]],"date-time":"2023-02-20T00:00:00Z","timestamp":1676851200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Manipal Academy of Higher Education, Manipal"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Orthop Surg Traumatol"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>An array of fixation and grafting techniques for scaphoid nonunion have been described over time, achieving varied results pertaining to union and scaphoid alignment. The aim of this study was to check for union rates and correction of scaphoid parameters achieved by our technique of using screw as a strut and cancellous compression grafting harvested from the distal radius by a single volar approach.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Retrospective analysis of all patients operated by the said technique was done from 2013 to 2019. Thirty-eight patients including 36 males and two females in the age range of 20\u201356\u00a0years were analyzed. Union rates, change in scaphoid alignment parameters and graft site characteristics were documented.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Of the patients analyzed, 5\/38 were nonunions of proximal pole, 19\/38 of waist and 14\/38 were of distal pole which included nonunions of cystic type or with humpback deformity. Patients were followed up for an average of 22.2\u00a0months and union was achieved in all cases with a mean period of 15.7\u2009\u00b1\u20093.7\u00a0weeks. There was significant improvement in the scaphoid alignment postoperatively. One case of implant migration and one case of scaphoid nonunion advanced collapse were noted. The mean duration of donor site healing was noted to be 16.9\u2009\u00b1\u20092.5\u00a0weeks except two outliers which took longer time. There were no cases of donor site fracture or other complications.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Union rates, correction of scaphoid parameters and minimal complications justifies this technique as a novel one in the management of scaphoid nonunion at all levels, with minimal donor site morbidity\u00a0and attained by the single volar approach.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00590-023-03485-2","type":"journal-article","created":{"date-parts":[[2023,2,23]],"date-time":"2023-02-23T17:14:38Z","timestamp":1677172478000},"page":"2821-2830","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Cancellous compression bone grafting using headless screw as a strut in scaphoid nonunion by a single volar approach"],"prefix":"10.1007","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6750-5239","authenticated-orcid":false,"given":"Anil K.","family":"Bhat","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0991-9537","authenticated-orcid":false,"given":"Sourab","family":"Shetty","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9899-0107","authenticated-orcid":false,"given":"Ashwath M.","family":"Acharya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,2,20]]},"reference":[{"key":"3485_CR1","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1016\/j.ocl.2012.09.003","volume":"44","author":"R Sendher","year":"2013","unstructured":"Sendher R, Ladd AL (2013) The scaphoid. Orthop Clin N Am 44:107\u2013120","journal-title":"Orthop Clin N Am"},{"key":"3485_CR2","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1097\/01.blo.0000205886.66081.9d","volume":"445","author":"JF Slade III","year":"2006","unstructured":"Slade JF III, Dodds SD (2006) Minimally invasive management of scaphoid nonunions. Clin Orthop Relat Res 445:108\u2013119","journal-title":"Clin Orthop Relat Res"},{"key":"3485_CR3","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1016\/j.jassh.2004.09.008","volume":"4","author":"KA Segalman","year":"2004","unstructured":"Segalman KA, Graham TJ (2004) Scaphoid proximal pole fractures and nonunions. J Am Soc Surg Hand 4:233\u2013249","journal-title":"J Am Soc Surg Hand"},{"key":"3485_CR4","doi-asserted-by":"publisher","first-page":"590","DOI":"10.1002\/jor.1100070418","volume":"7","author":"DK Smith","year":"1989","unstructured":"Smith DK, An KN, Cooney WP III, Linscheid RL, Chao EY (1989) Effects of a scaphoid waist osteotomy on carpal kinematics. J Orthop Res 7:590\u2013598","journal-title":"J Orthop Res"},{"key":"3485_CR5","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1007\/s00776-006-1025-x","volume":"11","author":"SP Steimann","year":"2006","unstructured":"Steimann SP, Adams JE (2006) Scaphoid fractures and nonunions: diagnosis and treatment. J Orthop Sci 11:424\u2013431","journal-title":"J Orthop Sci"},{"issue":"6","key":"3485_CR6","doi-asserted-by":"publisher","first-page":"933","DOI":"10.1016\/j.injury.2012.02.012","volume":"43","author":"HP Singh","year":"2012","unstructured":"Singh HP, Taub N, Dias JJ (2012) Management of displaced fractures of the waist of the scaphoid: meta-analyses of comparative studies. Injury 43(6):933\u2013939","journal-title":"Injury"},{"key":"3485_CR7","first-page":"385","volume-title":"The wrist: diagnosis and operative treatment","author":"RL Linscheid","year":"1998","unstructured":"Linscheid RL, Weber ER (1998) Scaphoid fractures and nonunion. In: Cooney WP, Linscheid RL, Dobyns JH (eds) The wrist: diagnosis and operative treatment. Mosby, St Louis, pp 385\u2013430"},{"key":"3485_CR8","doi-asserted-by":"publisher","first-page":"636","DOI":"10.1177\/1753193408090400","volume":"33","author":"J Braga-Silva","year":"2008","unstructured":"Braga-Silva J, Peruchi FM, Moschen GM, Gehlen D, Padoin AV (2008) A comparison of the use of distal radius vascularised bone graft and non-vascularised iliac crest bone graft in the treatment of nonunion of scaphoid fractures. J Hand Surg Eur 33:636\u2013640","journal-title":"J Hand Surg Eur"},{"issue":"4","key":"3485_CR9","doi-asserted-by":"publisher","first-page":"679","DOI":"10.1016\/0363-5023(89)90191-3","volume":"14","author":"PC Amadio","year":"1989","unstructured":"Amadio PC, Berquist TH, Smith DK, Ilstrup DM, Cooney WP III, Linscheid RL (1989) Scaphoid malunion. J Hand Surg Am 14(4):679\u2013687","journal-title":"J Hand Surg Am"},{"issue":"1","key":"3485_CR10","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1177\/1558944715614889","volume":"11","author":"BG Beutel","year":"2016","unstructured":"Beutel BG, Melamed E, Hinds RM, Gottschalk MB, Capo JT (2016) Mechanical evaluation of four internal fixation\u2014constructs for scaphoid fractures. Hand 11(1):72\u201377","journal-title":"Hand"},{"issue":"7","key":"3485_CR11","doi-asserted-by":"publisher","first-page":"e4","DOI":"10.2106\/JBJS.RVW.M.00074","volume":"2","author":"PC Rhee","year":"2014","unstructured":"Rhee PC, Jones DB Jr, Shin AY, Bishop AT (2014) Evaluation and treatment of scaphoid nonunions: a critical analysis review. JBJS Rev 2(7):e4","journal-title":"JBJS Rev"},{"issue":"8","key":"3485_CR12","doi-asserted-by":"publisher","first-page":"1500","DOI":"10.1016\/j.jhsa.2014.05.009","volume":"39","author":"ET Sayegh","year":"2014","unstructured":"Sayegh ET, Strauch RJ (2014) Graft choice in the management of unstable scaphoid nonunion: a systematic review. J Hand Surg Am 39(8):1500\u20131506","journal-title":"J Hand Surg Am"},{"key":"3485_CR13","doi-asserted-by":"publisher","first-page":"685","DOI":"10.1053\/jhsu.2002.34372","volume":"27","author":"GA Merrell","year":"2002","unstructured":"Merrell GA, Wolfe SW, Slade JF 3rd (2002) Treatment of scaphoid nonunions: quantitative meta-analysis of the literature. J Hand Surg Am 27:685\u2013691","journal-title":"J Hand Surg Am"},{"key":"3485_CR14","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1054\/jhsb.2001.0596","volume":"26","author":"JJ Dias","year":"2001","unstructured":"Dias JJ (2001) Definition of union after acute fracture and surgery for fracture nonunion of the scaphoid. J Hand Surg Br 26:321\u2013325","journal-title":"J Hand Surg Br"},{"issue":"5","key":"3485_CR15","doi-asserted-by":"publisher","first-page":"888","DOI":"10.1016\/S0363-5023(10)80156-X","volume":"16","author":"CF Larsen","year":"1991","unstructured":"Larsen CF, Mathiesen FK, Lindequist S (1991) Measurements of carpal bone angles on lateral wrist radiographs. J Hand Surg Am 16(5):888\u2013893","journal-title":"J Hand Surg Am"},{"issue":"2 Pt 2","key":"3485_CR16","doi-asserted-by":"publisher","first-page":"412","DOI":"10.1016\/0363-5023(89)90127-5","volume":"14","author":"R Nakamura","year":"1989","unstructured":"Nakamura R, Hori M, Imamura T, Horii E, Miura T (1989) Method for measurement and evaluation of carpal bone angles. J Hand Surg Am 14(2 Pt 2):412\u2013416","journal-title":"J Hand Surg Am"},{"key":"3485_CR17","first-page":"234","volume":"9","author":"A Eddeland","year":"1975","unstructured":"Eddeland A, Eiken O, Hellgren E, Ohlsson NM (1975) Fractures of the scaphoid. Scand J Plast Reconstr Surg 9:234\u2013239","journal-title":"Scand J Plast Reconstr Surg"},{"issue":"5","key":"3485_CR18","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1055\/s-0041-1735630","volume":"10","author":"T Nakamura","year":"2021","unstructured":"Nakamura T (2021) Natural history of scaphoid nonunion. J Wrist Surg 10(5):367","journal-title":"J Wrist Surg"},{"issue":"5","key":"3485_CR19","doi-asserted-by":"crossref","first-page":"e235","DOI":"10.3928\/01477447-20220608-03","volume":"45","author":"D Van Nest","year":"2022","unstructured":"Van Nest D, Ilyas AM (2022) Scaphoid nonunion: a review of surgical strategies. Orthopedics 45(5):e235\u2013e242","journal-title":"Orthopedics"},{"issue":"1","key":"3485_CR20","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1302\/0301-620X.66B1.6693468","volume":"66","author":"TJ Herbert","year":"1984","unstructured":"Herbert TJ, Fisher WE (1984) Management of the fractured scaphoid using a new bone screw. J Bone Joint Surg Br 66(1):114\u2013123","journal-title":"J Bone Joint Surg Br"},{"issue":"6","key":"3485_CR21","doi-asserted-by":"publisher","first-page":"569","DOI":"10.1016\/j.jhsa.2017.12.004","volume":"43","author":"I Esteban-Feliu","year":"2018","unstructured":"Esteban-Feliu I, Barrera-Ochoa S, Vidal-Tarrason N, Mir-Simon B, Lluch A, Mir-Bullo X (2018) Volar plate fixation to treat scaphoid nonunion: a case series with minimum 3 years of follow-up. J Hand Surg Am 43(6):569","journal-title":"J Hand Surg Am"},{"issue":"4","key":"3485_CR22","doi-asserted-by":"publisher","first-page":"701","DOI":"10.1016\/j.jhsa.2012.12.030","volume":"38","author":"MS Cohen","year":"2013","unstructured":"Cohen MS, Jupiter JB, Fallahi K, Shukla SK (2013) Scaphoid waist nonunion with humpback deformity treated without structural bone graft. J Hand Surg Am 38(4):701\u2013705","journal-title":"J Hand Surg Am"},{"issue":"2","key":"3485_CR23","doi-asserted-by":"publisher","first-page":"e20.00029","DOI":"10.2106\/JBJS.ST.20.00029","volume":"11","author":"PA Tavakolian","year":"2021","unstructured":"Tavakolian PA, Adams NS, Edwards SG (2021) Scaphoid nonunion volar plating with pure nonvascularized cancellous autograft. JBJS Essent Surg Tech 11(2):e20.00029","journal-title":"JBJS Essent Surg Tech"},{"key":"3485_CR24","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1055\/s-0040-1701512","volume":"9","author":"KE Shoji","year":"2020","unstructured":"Shoji KE, Simeone FJ, Ozkan S, Mudgal CS (2020) Outcomes of local bone graft and fixation of proximal pole scaphoid nascent nonunions and nonunions. J Wrist Surg 9:203\u2013208","journal-title":"J Wrist Surg"},{"issue":"12","key":"3485_CR25","doi-asserted-by":"publisher","first-page":"1829","DOI":"10.2106\/00004623-199612000-00005","volume":"78","author":"TE Trumble","year":"1996","unstructured":"Trumble TE, Clarke T, Kreder HJ (1996) Non-union of the scaphoid: treatment with cannulated screws compared with treatment with Herbert screws. J Bone Joint Surg Am 78(12):1829\u20131837","journal-title":"J Bone Joint Surg Am"},{"issue":"4","key":"3485_CR26","doi-asserted-by":"publisher","first-page":"625","DOI":"10.1016\/S0749-0712(21)01446-3","volume":"17","author":"DJ Nagle","year":"2001","unstructured":"Nagle DJ (2001) Scaphoid non-union treatment with cancellous bone graft and Kirschner-wire fixation. Hand Clin 17(4):625\u2013629","journal-title":"Hand Clin"},{"issue":"8","key":"3485_CR27","doi-asserted-by":"publisher","first-page":"625","DOI":"10.1016\/S0020-1383(01)00018-3","volume":"32","author":"LS Christodoulou","year":"2001","unstructured":"Christodoulou LS, Kitsis CK, Chamberlain ST (2001) Internal fixation of scaphoid non-union: a comparative study of three methods. Injury 32(8):625\u2013630","journal-title":"Injury"},{"issue":"1","key":"3485_CR28","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1177\/1753193417743438","volume":"43","author":"TJ Luchetti","year":"2018","unstructured":"Luchetti TJ, Rao AJ, Fernandez JJ, Cohen MS, Wysocki RW (2018) Fixation of proximal pole scaphoid nonunion with non-vascularized cancellous autograft. J Hand Surg Eur 43(1):66\u201372","journal-title":"J Hand Surg Eur"},{"issue":"9","key":"3485_CR29","doi-asserted-by":"publisher","first-page":"801","DOI":"10.1016\/j.jhsa.2021.05.014","volume":"46","author":"JP Higgins","year":"2021","unstructured":"Higgins JP, Giladi AM (2021) Scaphoid nonunion vascularized bone grafting in 2021: is avascular necrosis the sole determinant? J Hand Surg Am 46(9):801\u2013806","journal-title":"J Hand Surg Am"},{"key":"3485_CR30","doi-asserted-by":"publisher","first-page":"854","DOI":"10.1016\/j.injury.2006.04.120","volume":"37","author":"V Finsen","year":"2006","unstructured":"Finsen V, Hofstad M, Haugan H (2006) Most scaphoid non-unions heal with bone chip grafting and Kirschner-wire fixation: thirty-nine patients reviewed 10 years after operation. Injury 37:854\u2013859","journal-title":"Injury"},{"key":"3485_CR31","doi-asserted-by":"publisher","first-page":"627","DOI":"10.1302\/0301-620X.89B5.18183","volume":"89B","author":"C Ramamurthy","year":"2007","unstructured":"Ramamurthy C, Butler L, Nuttall D (2007) The factors affecting outcome after non-vascular bone grafting and internal fixation for nonunion of the scaphoid. J Bone Joint Surg 89B:627\u2013632","journal-title":"J Bone Joint Surg"},{"issue":"1","key":"3485_CR32","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1007\/s00590-016-1876-6","volume":"27","author":"E Meisel","year":"2017","unstructured":"Meisel E, Seal A, Yao CA, Ghiassi A, Stevanovic M (2017) Management of scaphoid nonunion with iliac crest bone graft and K-wire fixation. Eur J Orthop Surg Traumatol 27(1):23\u201331","journal-title":"Eur J Orthop Surg Traumatol"},{"issue":"7","key":"3485_CR33","doi-asserted-by":"publisher","first-page":"982","DOI":"10.2106\/00004623-198870070-00005","volume":"70","author":"HH Stark","year":"1988","unstructured":"Stark HH, Rickard TA, Zemel NP, Ashworth CR (1988) Treatment of ununited fractures of the scaphoid by iliac bone grafts and Kirschner-wire fixation. J Bone Joint Surg 70(7):982\u2013991","journal-title":"J Bone Joint Surg"},{"issue":"5","key":"3485_CR34","doi-asserted-by":"publisher","first-page":"686","DOI":"10.1016\/S0266-7681(98)80029-6","volume":"23","author":"MI Boyer","year":"1998","unstructured":"Boyer MI, Von Schroeder HP, Axelrod TS (1998) Scaphoid nonunion with avascular necrosis of the proximal pole. J Hand Surg 23(5):686\u2013690","journal-title":"J Hand Surg"},{"issue":"4","key":"3485_CR35","first-page":"450","volume":"23","author":"JH Yeo","year":"2018","unstructured":"Yeo JH, Kim JY (2018) Surgical strategy for scaphoid nonunion treatment. J Hand Surg 23(4):450\u2013462","journal-title":"J Hand Surg"},{"issue":"9","key":"3485_CR36","doi-asserted-by":"publisher","first-page":"1797","DOI":"10.1016\/j.jhsa.2015.05.003","volume":"40","author":"RM Pinder","year":"2015","unstructured":"Pinder RM, Brkljac M, Rix L, Muir L, Brewster M (2015) Treatment of scaphoid nonunion: a systematic review of the existing evidence. J Hand Surg 40(9):1797\u20131805","journal-title":"J Hand Surg"},{"issue":"4","key":"3485_CR37","first-page":"933","volume":"71","author":"M Leixnering","year":"2011","unstructured":"Leixnering M, Pezzei C, Weninger P, Mayer M, Bogner R, Lederer S, Figl M (2011) First experiences with a new adjustable plate for osteosynthesis of scaphoid nonunions. J Trauma 71(4):933\u2013938","journal-title":"J Trauma"}],"container-title":["European Journal of Orthopaedic Surgery &amp; Traumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00590-023-03485-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00590-023-03485-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00590-023-03485-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T04:06:51Z","timestamp":1694750811000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00590-023-03485-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,20]]},"references-count":37,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2023,10]]}},"alternative-id":["3485"],"URL":"https:\/\/doi.org\/10.1007\/s00590-023-03485-2","relation":{},"ISSN":["1432-1068"],"issn-type":[{"value":"1432-1068","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,20]]},"assertion":[{"value":"24 October 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 February 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 February 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This retrospective review study involving human participants was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The Institutional Ethics Committee of Manipal Academy of Higher Education (MAHE) approved this study. (IEC 464\/2020).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Appropriate consents wherever required have been taken.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}}]}}