Scaphoid nonunion fracture and results of the modified Matti-Russe technique


1 Department of Orthopaedic Surgery, Isfahan University of Medical Science, Isfahan, Iran

2 Medical Students Research Centre, Isfahan University of Medical Science, Isfahan, Iran


Background: The best treatment for scaphoid nonunion fractures is still controversial. The main aim of this study was to determine the results of the modified Matti-Russe method of surgery on scaphoid nonunion.
Materials and Methods: In this prospective interventional study, 30 patients with nonunion scaphoid fracture recruited from clinics of the Isfahan University of Medical Sciences between October 2007 and March 2011 underwent the modified Matti-Russe method of surgery. Union rate was evaluated four and six months after the procedure. Mayo wrist score (MWS) was calculated for the subjects six months after surgery.
Results: Mean age of the subjects was 25.9 ± 7.8 years, ranging from 16 to 35 years. Twenty-seven (90%) were men, and three (10%) were women. Four and six months after surgery, 10 (33%) and 26 (86.7%) subjects had a united fracture. Mean MWS was 75.0 ± 8.8 in all the subjects, ranging from 54 to 90 six months after surgery. Three subjects (10%) were grouped as excellent, 9 (30%) good, 16 (53.3%) satisfactory, and 3 (6.7%) poor.
Conclusion: A fracture or nonunion of the scaphoid bone can be a complex and troubling injury, but the modified Matti-Russe method showed satisfactory results six months after surgery.


Raju P, Kini SG. Fixation techniques for non-union of the scaphoid. J Orthop Surg (Hong Kong) 2011;19:80-4.  Back to cited text no. 1
Pao VS, Chang J. Scaphoid non-union: Diagnosis and treatment. Plast Reconstr Surg 2003;112:1666-77.  Back to cited text no. 2
Leslie I, Dickson R. The fractured carpal scaphoid. Natural history and factors influencing outcome. J Bone Joint Surg Br 1981;63:225-30.  Back to cited text no. 3
Khalid M, Jummani ZR, Kanagaraj K, Hussain A, Robinson D, Walker R. Role of MRI in the diagnosis of clinically suspected scaphoid fracture: Analysis of 611 consecutive cases and literature review. Emerg Med J 2010;27:266-9.  Back to cited text no. 4
Cooney W, Dobyns JH, Linscheid RL. Fractures of the scaphoid: A rational approach to management. Clin Orthop Relat Res 1980;149:90-7.  Back to cited text no. 5
Waters PM, Stewart SL. Surgical treatment of non-union and avascular necrosis of the proximal part of the scaphoid in adolescents. J Bone Joint Surg 2002;84:915-20.  Back to cited text no. 6
Triantafillopoulos I, Zoubos A, Babis G, Soucacos P. Orthopaedica et Traumatologica Hellenica. J Hellenic Ass Orthop Traumatol 2005;56.  Back to cited text no. 7
Herbert TJ, Fisher WE. Management of the fractured scaphoid using a new bone screw. J Bone Joint Surg Br 1984;66:114-23.  Back to cited text no. 8
Maruthainar N, Rasquinha V, Gallagher P. The treatment of scaphoid non-union: A review of a novel technique using precision bone grafting compared with Herbert screw fixation and bone graft. J Hand Surg Br 2000;25:427-30.  Back to cited text no. 9
Kawamura K, Chung KC. Treatment of scaphoid fractures and non-unions. J Hand Surg 2008;33:988-97.  Back to cited text no. 10
Filan S, Herbert T. Herbert screw fixation of scaphoid fractures. J Hand Surg Br 1996;78:519-29.  Back to cited text no. 11
Stark A, Broström L, Svartengren G. Scaphoid non-union treated with the Matti-Russe technique. Long-term results. Clin Orthop Relat Res 1987;214:175.  Back to cited text no. 12
Mulder J. The results of 100 cases of pseudarthrosis in the scaphoid bone treated by the Matti-Russe operation. J Hand Surg Br 1968;50:110-5.  Back to cited text no. 13
Panchal A, Kubiak EN, Keshner M, Fulkerson E, Paksima N. Comparison of fixation methods for scaphoid nonunions: A biomechanical model. Bull NYU Hosp Jt Dis 2007;65:271-5.  Back to cited text no. 14
Green D. The effect of avascular necrosis on Russe bone grafting for scaphoid non-union. J Hand Surg Am 1985;10:597-605.  Back to cited text no. 15
Parajuli N, Shrestha D, Dhoju D, Shrestha R, Sharma V. Scaphoid fracture: Functional outcome following fixation with herbert screw. Kathmandu Univ Med J (KUMJ) 2012;9:267-73.  Back to cited text no. 16
Ko³odziej R, Blacha J, Bogacz A, Mazurkiewicz T. Long-term outcome of scaphoid non-union treated by the Matti-Russe operation. Ortop Traumatol Rehabil 2006;8:507-12.  Back to cited text no. 17
Bullens P, Driesprong M, Lacroix H, Vegter J. Treatment of scaphoid non-union with a percutaneous corticocancellous bone graft. J Hand Surg Br 2005;30:365-8.  Back to cited text no. 18
Bertelli J, Peruchi F, Rost J, Tacca C. Treatment of scaphoid non-unions by a palmar approach with vascularised bone graft harvested from the thumb. J Hand Surg Eur Vol 2007;32:217-23.  Back to cited text no. 19
Jones Jr DB, Bürger H, Bishop AT, Shin AY. Treatment of scaphoid waist non-unions with an avascular proximal pole and carpal collapse. J Bone Joint Surg Am 2008;90:2616-25.  Back to cited text no. 20
Trumble T, Nyland W. Scaphoid non-unions: Pitfalls and pearls. Hand Clin 2001;17:611-24.  Back to cited text no. 21
Trezies A, Davis T, Barton N. Factors influencing the outcome of bone grafting surgery for scaphoid fracture non-union. Injury 2000;31:605-7.  Back to cited text no. 22
Gröner R, Zellner PR. Results of follow-up of Matti-Russe surgical treatment of scaphoid pseudarthroses. Handchir Mikrochir Plast Chir 1995;27:43-5.  Back to cited text no. 23
Mintzer CM, Waters PM. Surgical treatment of pediatric scaphoid fracture nonunions. J Pediatr Orthop 1999;19:236-9.  Back to cited text no. 24