Distal Scaphoid Excision for Symptomatic Scaphoid Nonunion | Dr. Daniel Gould

Dr. Daniel Gould co-authored this systematic review and meta-analysis published in HAND, examining distal scaphoid excision as a treatment option for patients with persistent, symptomatic scaphoid nonunion.

The scaphoid is a small bone in the wrist that can be difficult to heal following fracture. When a fracture fails to unite, patients may experience ongoing pain, reduced motion, loss of grip strength, and progressive changes within the wrist joint.

Traditional salvage procedures for persistent scaphoid nonunion can include proximal row carpectomy or four-corner fusion. Dr. Gould and his co-authors investigated whether distal scaphoid excision could offer a less extensive alternative while still providing meaningful improvements in pain and wrist function.

The researchers systematically reviewed six studies representing 70 patients. Across the available evidence, patients demonstrated improvements in wrist motion, grip strength, and patient-reported functional outcomes following distal scaphoid excision. Most patients were also able to return to work, and a high proportion reported satisfaction with their results.

The authors concluded that distal scaphoid excision may provide a relatively low-risk treatment option for appropriately selected patients with symptomatic scaphoid nonunion. Importantly, the procedure does not eliminate the possibility of pursuing more extensive salvage procedures in the future if they become necessary.