A new vascularized bone graft for scaphoid nonunion

Nonunion and avascular necrosis after scaphoid fractures continue to be problem sequelae because of unrecognized injuries, inadequate immobilization techniques, or insufficient treatment time. Screw fixation and inlay bone grafting techniques remain the options of choice, with successful union repor...

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Bibliographic Details
Published in:	The Journal of hand surgery (American ed.) Vol. 16; no. 3; p. 474
Main Authors:	Zaidemberg, C, Siebert, J W, Angrigiani, C
Format:	Journal Article
Language:	English
Published:	United States 01-05-1991
Subjects:	Adolescent Adult Bone Transplantation Carpal Bones - diagnostic imaging Carpal Bones - injuries Carpal Bones - surgery Female Fractures, Ununited - diagnostic imaging Fractures, Ununited - surgery Humans Male Methods Middle Aged Radiography Radius - surgery Wrist Joint - diagnostic imaging
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Summary:	Nonunion and avascular necrosis after scaphoid fractures continue to be problem sequelae because of unrecognized injuries, inadequate immobilization techniques, or insufficient treatment time. Screw fixation and inlay bone grafting techniques remain the options of choice, with successful union reported in approximately 90% of patients. However, prolonged immobilization with plaster up to 4 to 6 months is required with conventional techniques. With the use of standard latex injection techniques with vascular filling of vessels to less than 0.1 mm diameter in ten fresh cadaver dissections, we discovered a consistent vascularized bone graft source from the distal dorsoradial radius. We have used this vascularized bone graft source with good results in eleven patients with long-standing nonunion of the scaphoid. It is technically easy and seemingly offers the advantages of a decreased period of immobilization and a higher union rate.
ISSN:	0363-5023
DOI:	10.1016/0363-5023(91)90017-6