To investigate the methods and effect of wrist arthroscopy assisted minimally invasive bone grafting and internal fixation in the treatment of scaphoid fracture nonunion.

From October 2015 to October 2018, nine patients with unstable scaphoid fractures were treated by wrist arthroscope assisted minimally invasive method. All the nine patients were nonunion of scaphoid fracture, without scaphoid separation and proximal navicular collapse. The patients were evaluated for scaphoid fracture displacement, fracture end sclerosis and bone resorption defect according to preoperative imaging examination. During the operation, the sclerotic bone was planed from the middle carpal joint approach, and then the bone graft and internal fixation were performed. The Mayo score and VAS score were collected before and after the operation, the data between the two groups were compared by paired samples t test.

Nine patients were all followed up after the operation. The average follow-up time was (11.1±4.2) months. All the patients achieved bone union at the last follow-up. Mayo wrist score was (52.2±6.7) preoperatively, and (89.4±5.8) at the last follow-up (t=-19.8, P<0.001). VAS score decreased from (5.2±0.7) to (1.6±0.7) (t=15.6, P<0.001).

Wrist arthroscope assisted minimally invasive treatment of unstable scaphoid fracture nonunion is an effective option, using wrist arthroscopy technology to remove sclerotic bone, iliac bone fragments graft and internal fixation can achieve optimal outcomes.