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We studied the feasibility of percutaneous fixation without bone grafting in a consecutive series of 27 patients with established nonunion of an undisplaced fracture of the scaphoid and extensive local resorption of bone. They were treated by a single surgeon with rigid fixation alone, using a headless cannulated screw inserted through a volar percutaneous technique. Clinical examination, standard radiographs and CT confirmed that the fracture had united in all patients at a mean of 11.6 weeks (8 to 16), and that their functional scores had improved. <\/jats:p><jats:p> We concluded that extensive resorption at the fracture site is not an absolute indication for bone grafting, and that percutaneous fixation alone will eventually produce healing of ununited undisplaced fractures of the scaphoid regardless of the size of the gap. <\/jats:p>","DOI":"10.1302\/0301-620x.93b7.25418","type":"journal-article","created":{"date-parts":[[2011,6,25]],"date-time":"2011-06-25T21:07:37Z","timestamp":1309036057000},"page":"932-936","source":"Crossref","is-referenced-by-count":41,"title":["Percutaneous screw fixation without bone grafting for established scaphoid nonunion with substantial bone loss"],"prefix":"10.1302","volume":"93-B","author":[{"given":"M.","family":"Mahmoud","sequence":"first","affiliation":[{"name":"Cairo University Hospital, Kasr El Aini, Cairo, Egypt."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W.","family":"Koptan","sequence":"additional","affiliation":[{"name":"Cairo University Hospital, Kasr El Aini, Cairo, Egypt."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"42","reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.1016\/S0266-7681(97)80051-4"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.1053\/jhsu.1999.0761"},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.1016\/S0363-5023(80)80087-6"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.1016\/0266-7681(92)90118-L"},{"key":"R5","doi-asserted-by":"publisher","DOI":"10.1007\/BF00453208"},{"key":"R6","doi-asserted-by":"publisher","DOI":"10.1080\/00016470410001529"},{"key":"R7","doi-asserted-by":"crossref","unstructured":"Slade JF 3rd, Dodds SD. 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