Treatment of Scaphoid Nonunionusing a Pedicled Vascularized Bone Graft

Park, Min Jong; Lee, Jae Sung; Shin, Seong Kee

Abstract

PURPOSE
This study examined the clinical usefulness of a pedicled vascularized bone graft for the treatment of a scaphoid nonunion.
MATERIALS AND METHODS
Twenty-one patients with a scaphoid nonunion were treated with a pedicled vascularized bone graft using the 1, 2 intercompartmental supraretinacular branch of the radial artery. The average age of the patients was 29.3 years (range, 16-47) and the mean follow-up period was 19.6 months (range, 12-36). Punctate bleeding of the proximal fragment was evaluated intraoperatively and complete avascular necrosis was observed in 10 patients (47.5%).
RESULTS
Radiographic union was observed in 19 patients (90%). The other 2 patients were considered to have clinical union although it was unclear radiographically. The average union time was 10.7 weeks (range, 6-16). Eight of the ten patients with an avascular proximal pole showed radiographic union. Sixteen patients (76%) showed satisfactory subjective results at the time of the last follow up based on the scaphoid score.
CONCLUSION
Pedicled vascularized bone graft is a good method for treating a scaphoid nonunion and is strongly recommended in cases of scaphoid nonunion with proximal pole avascular necrosis.