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KMID : 0361620060410050871
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Journal of the Korean Orthopaedic Association
2006 Volume.41 No. 5 p.871 ~ p.876
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Treatment of Scaphoid Nonunion using a Pedicled Vascularized Bone Graft
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Park Min-Jong
Lee Jae-Sung
Shin Seong-Kee
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Abstract
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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.
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KEYWORD
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Scaphoid, Nonunion, Pedicled vascularized bone graft
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