Reconstruction of the Unsalvageable Proximal Pole in Scaphoid Nonunions Utilizing Rib Osteochondral Autograft

The patient was a 19-year-old right-hand-dominant collegiate football lineman who sustained a left scaphoid proximal pole fracture during a game. He was treated with closed reduction and percutaneous fixation with placement of a cannulated headless compression screw (Mini-Acutrak 2, Acumed, Hillsboro, OR). Postoperative radiographs demonstrated maintained reduction and appropriate fixation of the compression screw. Five months after surgery, the patient noted resolution of pain, excellent range of motion, and apparent radiographic union. He was allowed to return to sport, but subsequently reported pain with wrist motion and lifting that limited his functional ability.