{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T21:31:59Z","timestamp":1781299919828,"version":"3.54.1"},"reference-count":15,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Wrist Surg"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objective\u2003This study reports on the clinical outcomes of double screw fixation with autologous cancellous bone grafting and early active range of motion for delayed and nonunited scaphoid waist fractures with cavitary segmental bone loss.<\/jats:p><jats:p>\n          Patients and Methods\u2003Twenty-one consecutive patients underwent fixation using two 2.2\u2009mm antegrade headless compression screws with autologous distal radius cancellous bone graft. Postoperatively, patients were allowed early active motion with a resting splint until union was achieved. Patients were reviewed radiologically and clinically to assess for fracture union, complications, residual pain, wrist function, and return to work and recreational activities.<\/jats:p><jats:p>\n          Results\u2003All but one patient was male, and the mean age was 23 years (range, 15\u201338 years). The average time from initial injury was 16 months (range, 3\u2013144 months). Nineteen of 21 (90.5%) patients achieved union at a mean of 2.8 months (range, 1.4\u20139.2 months). Of the patients who failed, one underwent revision surgery with vascularized bone grafting at 10.6 months. The other patient refused further intervention as he was asymptomatic.<\/jats:p><jats:p>\n          Conclusion\u2003Double-screw fixation with bone grafting and early active range of motion is a safe and effective technique for management of delayed and nonunited unstable scaphoid fractures with cavitary bone loss. This potentially allows for earlier return to function, without compromise to union rates.<\/jats:p><jats:p>\n          Level of Evidence\u2003This is a Level IV, retrospective case series study.<\/jats:p>","DOI":"10.1055\/s-0040-1714252","type":"journal-article","created":{"date-parts":[[2020,7,30]],"date-time":"2020-07-30T23:02:17Z","timestamp":1596150137000},"page":"009-016","source":"Crossref","is-referenced-by-count":9,"title":["Clinical Outcomes of Double-Screw Fixation with Autologous Bone Grafting for Unstable Scaphoid Delayed or Nonunions with Cavitary Bone Loss"],"prefix":"10.1055","volume":"10","author":[{"given":"Eugene T.","family":"Ek","sequence":"additional","affiliation":[{"name":"Melbourne Orthopaedic Group, Windsor, Melbourne, Victoria, Australia"},{"name":"Division of Hand Surgery, Department of Orthopaedic Surgery, Monash University, Dandenong Hospital, Dandenong, Melbourne, Victoria, Australia"},{"name":"Department of Surgery, Monash University, Monash Medical Centre, Clayton, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul R.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Melbourne Orthopaedic Group, Windsor, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmel M.","family":"Bohan","sequence":"additional","affiliation":[{"name":"Melbourne Orthopaedic Group, Windsor, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gayan","family":"Padmasekara","sequence":"additional","affiliation":[{"name":"Melbourne Orthopaedic Group, Windsor, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2020,7,30]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.jcot.2013.01.009","article-title":"Managing scaphoid fractures. How we do it?","volume":"4","author":"V Gupta","year":"2013","journal-title":"J Clin Orthop Trauma"},{"issue":"04","key":"ref2","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1016\/j.surge.2012.03.004","article-title":"Acute fractures of the scaphoid bone: Systematic review and meta-analysis","volume":"10","author":"S Alshryda","year":"2012","journal-title":"Surgeon"},{"issue":"05","key":"ref3","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1016\/S0363-5023(80)80087-6","article-title":"The vascularity of the scaphoid bone","volume":"5","author":"R H Gelberman","year":"1980","journal-title":"J Hand Surg Am"},{"issue":"09","key":"ref4","doi-asserted-by":"crossref","first-page":"1797","DOI":"10.1016\/j.jhsa.2015.05.003","article-title":"Treatment of scaphoid nonunion: a systematic review of the existing evidence","volume":"40","author":"R M Pinder","year":"2015","journal-title":"J Hand Surg Am"},{"issue":"03","key":"ref5","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/j.jhsa.2017.10.005","article-title":"Scaphoid fracture fixation in a nonunion model: a biomechanical study comparing 3 types of fixation","volume":"43","author":"A Mandaleson","year":"2018","journal-title":"J Hand Surg Am"},{"issue":"07","key":"ref6","doi-asserted-by":"crossref","first-page":"1301","DOI":"10.1016\/j.jhsa.2014.02.030","article-title":"Scaphoid nonunions treated with 2 headless compression screws and bone grafting","volume":"39","author":"R M Garcia","year":"2014","journal-title":"J Hand Surg Am"},{"issue":"12","key":"ref7","doi-asserted-by":"crossref","first-page":"1829","DOI":"10.2106\/00004623-199612000-00005","article-title":"Non-union of the scaphoid. Treatment with cannulated screws compared with treatment with Herbert screws","volume":"78","author":"T E Trumble","year":"1996","journal-title":"J Bone Joint Surg Am"},{"issue":"02","key":"ref8","doi-asserted-by":"crossref","first-page":"160.e1","DOI":"10.1016\/j.jhsa.2018.05.023","article-title":"Outcomes of unstable scaphoid nonunion with segmental defect treated with plate fixation and autogenous cancellous graft","volume":"44","author":"J G Putnam","year":"2019","journal-title":"J Hand Surg Am"},{"issue":"01","key":"ref9","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/S0363-5023(98)80093-2","article-title":"Measurement of the scaphoid humpback deformity using longitudinal computed tomography: intra- and interobserver variability using various measurement techniques","volume":"23","author":"G I Bain","year":"1998","journal-title":"J Hand Surg Am"},{"issue":"01","key":"ref10","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1177\/230949901101900119","article-title":"Fixation techniques for non-union of the scaphoid","volume":"19","author":"P K Raju","year":"2011","journal-title":"J Orthop Surg (Hong Kong)"},{"issue":"11","key":"ref11","doi-asserted-by":"crossref","first-page":"1623","DOI":"10.1007\/s00402-016-2556-z","article-title":"Rotational stability in screw-fixed scaphoid fractures compared to plate-fixed scaphoid fractures","volume":"136","author":"J Jurkowitsch","year":"2016","journal-title":"Arch Orthop Trauma Surg"},{"issue":"01","key":"ref12","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1055\/s-0037-1606123","article-title":"A biomechanical comparison of screw and plate fixations for scaphoid fractures","volume":"7","author":"J Goodwin","year":"2018","journal-title":"J Wrist Surg"},{"issue":"02","key":"ref13","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1007\/s00402-018-3087-6","article-title":"Treatment of scaphoid waist nonunion by one, two headless compression screws or plate with or without additional extracorporeal shockwave therapy","volume":"139","author":"S Quadlbauer","year":"2019","journal-title":"Arch Orthop Trauma Surg"},{"issue":"05","key":"ref14","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1080\/00016470410001529","article-title":"Bone grafting the scaphoid nonunion: a systematic review of 147 publications including 5,246 cases of scaphoid nonunion","volume":"75","author":"B Munk","year":"2004","journal-title":"Acta Orthop Scand"},{"issue":"02","key":"ref15","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1002\/ca.21198","article-title":"Osseous microarchitecture of the scaphoid: Cadaveric study of regional variations and clinical implications","volume":"25","author":"S B Lee","year":"2012","journal-title":"Clin Anat"}],"container-title":["Journal of Wrist Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0040-1714252.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,1]],"date-time":"2021-02-01T23:59:38Z","timestamp":1612223978000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0040-1714252"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,30]]},"references-count":15,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2021,2,1]]},"published-print":{"date-parts":[[2021,2]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0040-1714252","relation":{},"ISSN":["2163-3916","2163-3924"],"issn-type":[{"value":"2163-3916","type":"print"},{"value":"2163-3924","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,30]]}}}