{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T23:10:12Z","timestamp":1758669012057,"version":"3.44.0"},"reference-count":25,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Wrist Surg"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Due to the unique morphology and tenuous vascularity, proximal pole fractures of the scaphoid are prone to nonunion if neglected. The vascular anatomy and the understanding that the blood flow to the proximal pole is retrograde in nature, has supported the concept of disruption of blood flow to the proximal pole with the possibility of avascular necrosis in a nonunited proximal pole. Historically, surgical management at this stage has favored the use of a vascularized bone graft over a nonvascularized bone graft to achieve union and good outcomes. However, the current literature seems to deviate from the long-standing understanding of proximal pole nonunion and its relationship to avascular necrosis. Not only does it state that avascular necrosis is extremely rare, but it also advocates arthroscopic bone grafting of proximal pole nonunions using morselized nonvascularized bone graft which has been proven to be a highly successful operation. Here, in our paper, we present a short series of some unique but surgically challenging cases of proximal pole nonunion and our successful management by bone grafting and fixing them arthroscopically. Our experience and invariably the experience of many may indicate that arthroscopic bone grafting and fixation may be the correct choice of surgery for proximal pole nonunion of the scaphoid bone.<\/jats:p>","DOI":"10.1055\/s-0044-1788673","type":"journal-article","created":{"date-parts":[[2024,9,12]],"date-time":"2024-09-12T19:16:02Z","timestamp":1726168562000},"page":"444-453","source":"Crossref","is-referenced-by-count":0,"title":["Can Any Proximal Pole Scaphoid Fracture Nonunion be Treated with Arthroscopic Bone Grafting? A Series of Case Reports of Successes in Challenging and Unique Cases"],"prefix":"10.1055","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8885-5665","authenticated-orcid":false,"given":"Muntasir Mannan","family":"Choudhury","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Sengkang General Hospital, Sengkang, Singapore"},{"name":"Department of Hand and Reconstructive Microsurgery, Singapore General Hospital, Singapore"},{"name":"Deapartment of Musculoskeletal Sciences, ACP, SingHealth Duke-NUS Musculoskeletal Sciences ACP, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,9,12]]},"reference":[{"issue":"03","key":"ref1","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1016\/j.hcl.2011.06.003","article-title":"Minimal invasive management of scaphoid fractures: from fresh to nonunion","volume":"27","author":"W Y Wong","year":"2011","journal-title":"Hand Clin"},{"issue":"05","key":"ref2","doi-asserted-by":"crossref","first-page":"308","DOI":"10.5435\/00124635-200705000-00009","article-title":"Scaphoid nonunion","volume":"15","author":"T Waitayawinyu","year":"2007","journal-title":"J Am Acad Orthop Surg"},{"issue":"06","key":"ref3","doi-asserted-by":"crossref","first-page":"988","DOI":"10.1016\/j.jhsa.2008.04.026","article-title":"Treatment of scaphoid fractures and nonunions","volume":"33","author":"K Kawamura","year":"2008","journal-title":"J Hand Surg Am"},{"issue":"06","key":"ref4","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.2106\/00004623-196648060-00010","article-title":"The extraosseous and intraosseous blood supply of the scaphoid bone","volume":"48","author":"J Taleisnik","year":"1966","journal-title":"J Bone Joint Surg Am"},{"issue":"04","key":"ref5","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1007\/s00776-006-1025-x","article-title":"Scaphoid fractures and nonunions: diagnosis and treatment","volume":"11","author":"S P Steinmann","year":"2006","journal-title":"J Orthop Sci"},{"issue":"03","key":"ref6","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1055\/s-0036-1597575","article-title":"A critical appraisal of vascularized bone grafting for scaphoid nonunion","volume":"6","author":"R K Alluri","year":"2017","journal-title":"J Wrist Surg"},{"issue":"04","key":"ref7","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1053\/jhsu.2002.34372","article-title":"Treatment of scaphoid nonunions: quantitative meta-analysis of the literature","volume":"27","author":"G A Merrell","year":"2002","journal-title":"J Hand Surg Am"},{"key":"ref8","first-page":"317","article-title":"Reevaluation of the scaphoid fracture: what is the current best evidence?","volume":"69","author":"G A Buijze","year":"2020","journal-title":"Instr Course Lect"},{"issue":"04","key":"ref9","doi-asserted-by":"crossref","first-page":"e19","DOI":"10.2106\/JBJS.RVW.19.00181","article-title":"Management of proximal pole scaphoid nonunions: a critical analysis review","volume":"9","author":"E R Wagner","year":"2021","journal-title":"JBJS Rev"},{"issue":"03","key":"ref10","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/j.hcl.2019.03.003","article-title":"Arthroscopic management of scaphoid nonunion","volume":"35","author":"W C Wong","year":"2019","journal-title":"Hand Clin"},{"issue":"01","key":"ref11","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1177\/1753193417732003","article-title":"Success of scaphoid nonunion surgery is independent of proximal pole vascularity","volume":"43","author":"S K Rancy","year":"2018","journal-title":"J Hand Surg Eur Vol"},{"issue":"01","key":"ref12","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1177\/1753193417743438","article-title":"Fixation of proximal pole scaphoid nonunion with non-vascularized cancellous autograft","volume":"43","author":"T J Luchetti","year":"2018","journal-title":"J Hand Surg Eur Vol"},{"issue":"08","key":"ref13","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1302\/0301-620X.104B8.BJJ-2022-0198.R1","article-title":"Arthroscopic bone graft and fixation for proximal scaphoid nonunions","volume":"104-B","author":"F Wu","year":"2022","journal-title":"Bone Joint J"},{"issue":"06","key":"ref14","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1055\/s-0041-1742097","article-title":"Arthroscopic bone graft and internal fixation of non-union of the proximal pole of the scaphoid: surgical technique and outcomes","volume":"11","author":"J Ecker","year":"2022","journal-title":"J Wrist Surg"},{"key":"ref15","first-page":"197","article-title":"Scaphoid fractures: current treatments and techniques","volume":"52","author":"W P Cooney III","year":"2003","journal-title":"Instr Course Lect"},{"issue":"10","key":"ref16","doi-asserted-by":"crossref","first-page":"1414","DOI":"10.2106\/00004623-199910000-00006","article-title":"Vascularized bone graft from the iliac crest for the treatment of nonunion of the proximal part of the scaphoid with an avascular fragment","volume":"81","author":"M Gabl","year":"1999","journal-title":"J Bone Joint Surg Am"},{"issue":"03","key":"ref17","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1016\/S0266-7681(98)80049-1","article-title":"Vascularized bone graft from the palmar carpal artery for treatment of scaphoid nonunion","volume":"23","author":"C Mathoulin","year":"1998","journal-title":"J Hand Surg Br"},{"issue":"06","key":"ref18","doi-asserted-by":"crossref","first-page":"883","DOI":"10.2106\/00004623-199506000-00009","article-title":"Non-union of the scaphoid. Revascularization of the proximal pole with implantation of a vascular bundle and bone-grafting","volume":"77","author":"D L Fernandez","year":"1995","journal-title":"J Bone Joint Surg Am"},{"issue":"03","key":"ref19","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1016\/0363-5023(91)90017-6","article-title":"A new vascularized bone graft for scaphoid nonunion","volume":"16","author":"C Zaidemberg","year":"1991","journal-title":"J Hand Surg Am"},{"issue":"03","key":"ref20","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1016\/S0266-7681(97)80420-2","article-title":"Treatment of scaphoid nonunions with a vascularized bone graft based on the first dorsal metacarpal artery","volume":"22","author":"A Yuceturk","year":"1997","journal-title":"J Hand Surg Br"},{"issue":"03","key":"ref21","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1016\/S0363-5023(86)80141-1","article-title":"Percutaneous pinning of symptomatic scaphoid nonunions","volume":"11","author":"M Q Cosio","year":"1986","journal-title":"J Hand Surg Am"},{"issue":"02","key":"ref22","first-page":"91","article-title":"Iliac crest autogenous bone grafting: donor site complications","volume":"9","author":"J G Seiler III","year":"2000","journal-title":"J South Orthop Assoc"},{"issue":"01","key":"ref23","doi-asserted-by":"crossref","first-page":"48","DOI":"10.2106\/00004623-199901000-00007","article-title":"Results of Herbert-screw fixation with bone-grafting for the treatment of nonunion of the scaphoid","volume":"81","author":"B M Rajagopalan","year":"1999","journal-title":"J Bone Joint Surg Am"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1097\/01.blo.0000205886.66081.9d","article-title":"Minimally invasive management of scaphoid nonunions","volume":"445","author":"J F Slade III","year":"2006","journal-title":"Clin Orthop Relat Res"},{"issue":"04","key":"ref25","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1177\/145749690809700402","article-title":"Retrospective review of 234 scaphoid fractures and nonunions treated with arthroscopy for union and complications","volume":"97","author":"J F Slade III","year":"2008","journal-title":"Scand J Surg"}],"container-title":["Journal of Wrist Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0044-1788673.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T22:43:42Z","timestamp":1758667422000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0044-1788673"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,12]]},"references-count":25,"journal-issue":{"issue":"05","published-online":{"date-parts":[[2025,9,23]]},"published-print":{"date-parts":[[2025,10]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0044-1788673","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2163-3916","2163-3924"],"issn-type":[{"type":"print","value":"2163-3916"},{"type":"electronic","value":"2163-3924"}],"subject":[],"published":{"date-parts":[[2024,9,12]]}}}