Dorsal approach to scaphoid nonunion

The surgical approach for treatment of scaphoid nonunion usually involves various combinations of screws and Kirschner wires, with or without bone grafts. This article reports our results with 36 dorsal-approach bone grafting procedures for treatment of scaphoid nonunion with Kirschner wires. Union was achieved in 89%. The average follow-up was 5 years. Flexion/extension averaged 76% of the opposite wrist, and grip strength was 88% of the opposite hand. Ninety-one percent of the employed patients returned to their original jobs. The dorsal approach provides satisfactory exposure for fragment reduction and bone grafting.