A new vascularized bone graft for scaphoid nonunion

• 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
• ISSN: 0363-5023
• DOI: 10.1016/0363-5023(91)90017-6

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.