Minimally Invasive Surgery for Trapezoid Nonunion: Case Report and Review of the Literature

J Hand Surg Asian Pac Vol. 2023 Aug;28(4):494-498. doi: 10.1142/S2424835523720141. Epub 2023 Sep 25.

Abstract

We report a case of trapezoid nonunion diagnosed 3 months post injury. A 25-year-old male patient felt continuous wrist pain after being injured. His radiograph showed non-union with sclerotic change and bone resorption. He was planned for surgery, and this was done using a minimally invasive technique. Via a dorsal approach, we percutaneously drilled to the nonunion site and freshened the fracture ends. Bone plugs were harvested from the iliac crest using a bone marrow biopsy needle and packed into the nonunion site. The fracture was then fixed with a cannulated headless compression screw. This procedure could be performed without injuring the ligaments around the trapezoid. The patient was immobilised for 4 weeks, and bone union was achieved 6 months after surgery. He had full range of finger and wrist motion and no pain at the final follow-up. Level of Evidence: Level V (Therapeutic).

Keywords: Bone graft; Bone marrow biopsy needle; Minimally invasive surgery; Nonunion; Trapezoid.

Publication types

  • Review
  • Case Reports

MeSH terms

  • Adult
  • Bone Transplantation / methods
  • Fracture Fixation, Internal / methods
  • Fractures, Bone* / surgery
  • Fractures, Ununited* / diagnostic imaging
  • Fractures, Ununited* / surgery
  • Humans
  • Male
  • Minimally Invasive Surgical Procedures
  • Scaphoid Bone* / surgery