Revisional scaphoid reconstruction for failed screw fixation of scaphoid fractures via the hand trauma plate system

Scaphoid fractures are relatively common and account for a significant proportion of wrist fractures [1]. The management of scaphoid fractures involves a multifaceted approach that considers the fracture location, displacement, and patient-specific factors. Treatment typically involves immobilization through casting or splinting to allow the bone to heal, with the duration varying on the basis of the fracture location and stability [2,3]. In cases where displacement or instability is present, surgical intervention, often involving internal fixation with screws, may be necessary to ensure optimal healing [1]. The frequency of nonunion following surgical fixation for scaphoid fractures also varies [4]. Factors associated with an increased risk of nonunion following screw fixation include proximal pole fractures, delayed diagnosis and treatment, inadequate reduction of the fracture, and poor screw positioning [5,6]. If the initial surgical fixation fails, revisional surgery remains challenging. The union rates for second-try reconstruction range from 56 % to 100 % [[7], [8], [9], [10], [11], [12], [13]]. Data addressing this small group of patients are very limited. The purpose of this study was to report the results of revision surgery using a hand trauma plate fixation system with a bone graft.

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