Clinical study of autogous cancellous bone and bone marrow graft for treatment of scaphoid nonunion

Objective To evaluate the clinical results of autologous cancellous bone marrow graft for treatment of old scaphoid nonunion and proximal pole seapboid fractures.Methods Thirty-six cases of scaphoid nonunion were treated.After debridement of the necrotic fraeture ends,the proximal and distal parts of the scaphoid were reduced and fixed with Kirschner wire along with cancellons bone graft from either the iliac crest or distal radius.5 ml autologous bone marrow from the iliac was injected to the fracture site.CR-X ray films were collected weekly from 6th week after the operation till healing of the fracture.The time of bone union and return to work was recorded.Results The patients were followed-up for 10 weeks to 5 years.Bone union was achieved in all cases.The duration of bone union ranged from 8 to 12 weeks,the average being 9.3 weeks. Range of motion was the same as that of the healthy side in 35 cases after rehabilitation.Those patients were pain free and returned to their original work.Wrist movement in 1 case was restricted and impaired to some extent. There was also motion pain but it had obviously improved as compared to preoperative level.Conclusion Autologons cancellous bone and bone marrow graft is an effective method for treatment of scaphoid nonunion.It shortenes healing time,increases healing rate,and retains the original anatomical and biomechanical properties.