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©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Feb 18, 2026; 17(2): 112889
Published online Feb 18, 2026. doi: 10.5312/wjo.v17.i2.112889
Published online Feb 18, 2026. doi: 10.5312/wjo.v17.i2.112889
Necessity of grafting in scaphoid nonunion fixation: A comparative outcome analysis
Amr Elshahhat, Moheib Ahmed, Ahmed Saleh, Yasser Abed, Hany Elashmawy, Khaled Nour, Department of Orthopedic Surgery, Mansoura University, Mansoura 33516, Dakahlia, Egypt
Author contributions: All authors contributed to the study conception and design; Elshahhat A, Ahmed M, Saleh A, and Abed Y contributed to material preparation; Elshahhat A and Elashmawy H contributed to data collection and analysis; Elshahhat A and Nour K contributed to the first draft of the manuscript. All authors were responsible for critical revision, and final approval of the manuscript.
Institutional review board statement: This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Medical Research Ethics Committee, Institutional Review Board of Mansoura Faculty of Medicine, Mansoura University (approve No. R.24.08.2743).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data is available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Amr Elshahhat, MD, PhD, Department of Orthopedic Surgery, Mansoura University, Algomhoria Street, Mansoura 33516, Dakahlia, Egypt.
Received: August 8, 2025
Revised: September 25, 2025
Accepted: December 11, 2025
Published online: February 18, 2026
Processing time: 180 Days and 7.8 Hours
Revised: September 25, 2025
Accepted: December 11, 2025
Published online: February 18, 2026
Processing time: 180 Days and 7.8 Hours
Core Tip
Core Tip: This study compares graft-augmented and graft-less fixation in stable scaphoid nonunions. While grafting significantly shortened healing time, graft-less fixation yielded superior functional outcomes, particularly in grip strength and wrist motion. Subgroup analysis highlights the role of bone loss, nonunion duration, and smoking in guiding treatment choice. These findings support individualized fixation strategies and question the routine necessity of bone grafting in select cases.