[Ortho] Несращение ладьевидной кости после остеосинтез

[David Nelson]

I am not sure if the differential of a nonunion vs. pseudoarthrosis means much in this context. The distal pole of the screw has a lucency, so the 
nonunion is most likely unstable and moving. It needs revision. The radial styloid does not have evidence of DJD, so I do not think it needs to be resected.  The surgery will probably require an open revision, removal of necrotic bone and soft tissue interposition, and would benefit from some 
distal radial autograft.  The patient needs to refrain from smoking and I would use a case to be sure they do not move for a while. A stiff wrist is not a bad outcome; a bad outcome is a painful wrist.

David Nelson
hand surgeon, San Francisco