The meaning of carpal instability in the treatment of pseudoarthrosis of the scaphoid [IL SIGNIFICATO DELL'INSTABILITA CARPALE NEL TRATTAMENTO DELLE PSEUDOARTROSI DELLO SCAFOIDE]

In this paper the authors examine the role of carpal instability in the surgical treatment of pseudoarthrosis of the scaphoid. Carpal alignment was studied using standard X-ray whereas NMR allowed the direct display of legamentous lesions. The review of 20 cases in whom consolidation had been achieved following treatment with osteosynthesis and cortico-spongious transplant revealed the frequency of ligamentous alterations and carpal misalignment syndromes in scaphoid pseudoarthrosis. The presence of instability does not result in clinical deficit nor does it appear to influence the consolidation of pseudoarthrosis which seems to be linked to the vascular condition of the stumps and an adequate operating technique.