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Fixation with two headless compression screws and a distal-radius bone graft for proximal scaphoid nonunion with dorsal intercalated segment instability deformity: a report of three cases
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Seonjeong Lee, Won Sun Lee, Jae Kwang Kim
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J Musculoskelet Trauma 2026;39(3):252-261. Published online July 7, 2026
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DOI: https://doi.org/10.12671/jmt.2026.00136
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Abstract
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- Proximal scaphoid nonunion is difficult to treat because the proximal fragment is small and biologically compromised. Secure fixation can be especially challenging when dorsal intercalated segment instability (DISI) is present and requires correction. We report three male patients with proximal scaphoid nonunion and DISI deformity who underwent volar fixation with two 2.4-mm headless compression screws and cancellous bone graft harvested from the distal radius at the Lister tubercle. Preoperative computed tomography confirmed a proximal nonunion line and proximal fragment dimensions considered sufficient for dual-screw fixation, and magnetic resonance imaging showed no definite avascular necrosis. Early postoperative computed tomography showed maintained fixation and alignment in all three patients. Although CT-confirmed union at final follow-up was not uniformly available, radiographic union defined on plain radiographs was achieved in all cases without loss of alignment or carpal collapse. Carpal alignment improved in two patients, but DISI persisted in one. One patient underwent secondary removal of a preexisting loose body and one screw. This small case series suggests that dual-screw fixation with cancellous grafting may be technically feasible in selected proximal scaphoid nonunions with concomitant DISI.
Level of evidence: V.
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Surgical Correction and Osteosynthesis for Cranial Displaced Pelvic Nonunion: Technical Note and Two Cases Report Regarding Anterior Correction and Osteosynthesis Following Posterior Release
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Kwang Cheon Choi, Ji Yoon Ha, Weon Yoo Kim
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J Korean Fract Soc 2014;27(2):151-156. Published online April 30, 2014
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DOI: https://doi.org/10.12671/jkfs.2014.27.2.151
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Abstract
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- Nonunion of an unstable pelvic fracture with cranial displacement pelvic surgery is technically difficult due to a large amount of bleeding and the risk of nerve damage. In addition, surgical correction of leg length discrepancy by reduction of a dislocated sacroiliac joint is in high demand. Nevertheless, when a patient is strongly disabled by a pelvic deformity, surgical correction may be necessary. Two patients with pelvic deformity were treated successfully by surgical correction and osteosynthesis.
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