Suture Anchor Fixation for Scaphoid Nonunions With Small Proximal Fragments: Report of 11 Cases

Purpose To describe the use of 2 suture anchors as the fixation devices in the management of 11 patients with scaphoid proximal pole nonunions with small proximal fragments. Methods In a prospective study, 11 patients with proximal pole scaphoid nonunions (10 with small proximal fragments and 1 with an oblique nonunion line) were evaluated before surgery by standard wrist x-rays and functional wrist scores including a visual analog scale (VAS), Mayo wrist score, and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH). The nonunion site was fixed with 2 suture anchors supplemented with autologous cancellous bone graft. Postoperative evaluations consisting of functional wrist scores and evaluation of radiological union were performed 9 months after surgery. Results At the end of the study, we observed union in 10 of the 11 patients. The QuickDASH and VAS scores showed significant improvement, and 10 patients had satisfactory Mayo scores. Conclusions We propose the technique of suture anchor fixation for cases of proximal scaphoid nonunion in which secure internal fixation with common techniques is challenging because of the small size of the proximal fragment and the obliquity of the nonunion site. Type of study/level of evidence Therapeutic IV.