BACKGROUND: This study aimed to evaluate the clinical outcomes, with a minimum follow-up of two years, in athletes with scaphoid nonunion and minimal sclerosis who were treated with arthroscopically assisted percutaneous internal fixation augmented by injection of demineralized bone matrix (DBM) and bone marrow aspirate concentrate (BMAC). METHOD: Between January 2021 and January 2024, a consecutive series of 17 patients with early-stage scaphoid fracture nonunion, characterized by sclerosis or resorption at the nonunion site, were treated with arthroscopically assisted osteosynthesis using demineralized bone matrix (DBM) and bone marrow aspirate concentrate (BMAC), combined with percutaneous internal fixation. Preoperative and postoperative assessments included clinical parameters (grip strength and range of motion), radiographic evaluation, functional outcomes using the Mayo Modified Wrist Score, and patient satisfaction. RESULTS: The study sample consisted of 15 men and 2 women, with a mean age of 30.5 years (range, 20 to 45 years). Clinical follow-up was conducted at a mean of 26 months (range, 24-30 months), during which we recorded radiographic union and return to activity. Bony union was confirmed in 15 of 17 patients (88%) at a mean of 15.4 weeks, based on clinical examination and standard radiographic assessment. According to the Mayo Modified Wrist Score, 11 patients achieved excellent outcomes and 4 achieved good outcomes. Overall, 15 of 17 patients (88%) returned to their pre-injury level of work or sports activities. CONCLUSIONS: Arthroscopically assisted osteosynthesis using DBM and BMAC, combined with percutaneous screw fixation, may represent a feasible and minimally invasive approach for promoting union and scaphoid healing in early-stage nonunion in athletes. LEVEL OF EVIDENCE: Level IV, case series.
Lee et al. (Thu,) studied this question.