We studied the results in thirty patients who had grafting of an
ununited fracture of the carpal scaphoid bone. Psychiatric evaluations
revealed that the thirteen patients who had a non-union of the initial
scaphoid bone graft had significant psychiatric problems, whereas the
seventeen patients in whom the non-union had healed after initial
bone-grafting of the scaphoid did not have psychiatric abnormalities.
Technically successful surgical revisions in the first group of patients
did not result in significant clinical improvement. We concluded that most
failures of the bone grafts were related to non-compliance on the part of
the patient and that some of the operations could have been avoided if the
underlying psychiatric problems had been recognized preoperatively.