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Severe Scaphoid Nonunion with Screw Loosening and Arthritis

A 32 yo male presented with a painful left wrist 4 years after scaphoid nonunion surgery. X-rays showed continued nonunion, early arthritis, and loosening of the screw. CT scans revealed severe deformity and the migrating screw touching the radius. This case highlights the use of a hybrid Russe surgery for bone transfer, reconstruction, and successful healing at 7 months post-op.

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Severe Scaphoid Nonunion with Screw Loosening and Arthritis

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  1. A. 32 yo male presented for treatment of his painful left wrist 4 years after surgery for a scaphoid nonunion. Xrays showed continued nonunion, early arthritis, and loosening of the screw. The prominent screw caused localized loss of his joint cartilage, which can cause worsening arthritis.

  2. B. CT scan demonstrates the severe deformity of the scaphoid and migrating screw, touching the radius.

  3. C. High resolution CT scan of the wrist to assist in operative planning.

  4. D. Computed tomography demonstrating complete healing with bone graft strut bridging nonunion at 10weeks postop.

  5. E. 7 months following Hybrid Russe surgery, designed by Drs. Lee and Wolfe, to transfer bone from his radius to his scaphoid, reconstructing anatomic alignment and integrity of the scaphoid, solid healing and return to sports and activities.

  6. F. Range of motion at 7 months postop.

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