Treatment of Preiser Disease with Vascularized Bone Graft from the Distal Radius: A Report of Two Cases

A vascularized bone graft from the dorsoradial aspect of the distal radius was used with internal fixation to treat nonunion of the scaphoid in ten patients who had not received any previous surgical treatment. Five cases were classified as Lichtman type I and five as type II. The average age was 30 years (range, 18–40 years). Associated avascular necrosis was observed in five cases. Post-operatively pain was relieved and union was achieved in all cases. The mean time to union was 6.5 weeks. Range of motion, grip strength and pinch strength were also restored satisfactorily. These results suggest that this vascularized bone graft should be used as the primary procedure in Lichtman type I and II of scaphoid nonunions, regardless of the presence of avascular necrosis of the proximal pole.

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Injerto óseo vascularizado pediculado del radio distal para tratar la seudoartrosis recalcitrante del cúbito. [Vascularized bone graft of the distal radius for recalcitrant ulnar pseudoarthrosis.]

Revista de la Asociación Argentina de Ortopedia y Traumatología ◽

10.15417/763 ◽

2018 ◽

Vol 83 (1) ◽

pp. 31

Author(s):

Ezequiel Ernesto Zaidenberg ◽

Ezequiel Martinez ◽

Martin Pastrana ◽

Fernando Juarez Cesca ◽

Federico Olazarri ◽

...

Keyword(s):

Bone Graft ◽

Distal Radius ◽

Vascularized Bone Graft ◽

Vascularized Bone

IntroducciónEl objetivo de este trabajo es presentar los resultados clínicos y radiológicos de una serie de pacientes tratados con el injerto óseo vascularizado (IOV) pediculado del radio distal para pseudoartrosis recalcitrantes de cubito diafisario o proximal. Materiales y MétodosSe realizo un estudio retrospectivo donde se incluyeron pacientes con pseudoartrosis de cubito diafisario o proximal con defectos menores a 6 centímetros, con al menos tres cirugías previas y con un seguimiento mínimo de 2 años tratados con IOV pediculado del radio distal. Se registró en número de cirugías previas. Se evaluó el rango de movimiento de codo y de muñeca, la fuerza de puño comparativa, la Escala Visual analógica (EVA) para dolor, el cuestionario QuickDASH y el Score de Mayo para codo. ResultadosSiete pacientes fueron incluidos. La edad media fue de 42 años (rango 26-64). El número promedio de cirugías anteriores fue 4 (3-7). El seguimiento medio fue de 21 meses (rango 24-36). Todas las pseudoartrosis consolidaron. El score de Mayo fue bueno en 4 pacientes, excelente en 2 pacientes y moderado en un paciente. El QuickDASH posoperatorio promedio fue de 13 (0-29). El arco de flexo-extensión de la muñeca fue del 81% del contralateral. El rango de movilidad de codo fue > 100° en 5 pacientes y entre 50° - 100° en 2 pacientes. ConclusiónEl injerto óseo vascularizado pediculado del radio distal es una alternativa efectiva para el tratamiento de la pseudoartrosis de cubito.

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Vascularized Bone Graft from the Palmar Carpal Artery for Treatment of Scaphoid Nonunion

Journal of Hand Surgery (European Volume) ◽

10.1016/s0266-7681(98)80049-1 ◽

1998 ◽

Vol 23 (3) ◽

pp. 318-323 ◽

Cited By ~ 121

Author(s):

C. MATHOULIN ◽

M. HAERLE

Keyword(s):

Bone Graft ◽

Distal Radius ◽

Vascularized Bone Graft ◽

Scaphoid Nonunion ◽

Ulnar Aspect ◽

Vascularized Bone

We report the use of a bone graft harvested from the palmar and ulnar aspect of the distal radius and vascularized by the palmar carpal artery for the treatment of scaphoid nonunion in 17 patients, ten of whom had already had unsuccessful surgery. Union was obtained in all cases at an average of 60 days (range, 45–90 days). The average follow-up was 16 months (range, 12–36 months). There were no failures.

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The Capsular-Based Vascularized Bone Graft from the Dorsal Distal Radius

Art of Microsurgical Hand Reconstruction ◽

10.1055/b-0034-78115 ◽

2013 ◽

Keyword(s):

Bone Graft ◽

Distal Radius ◽

Vascularized Bone Graft ◽

Vascularized Bone

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The Fourth Extensor Compartment Artery Vascularized Bone Graft of the Distal Radius for CMC Fusion in the Treatment of Carpal Boss: A Case Report

Hand ◽

10.1177/1558944716672203 ◽

2016 ◽

Vol 12 (5) ◽

pp. NP88-NP91 ◽

Cited By ~ 1

Author(s):

Jorge G. Boretto ◽

David Fernandez-Fernandez ◽

Gerardo Gallucci ◽

Pablo De Carli

Keyword(s):

Bone Graft ◽

Distal Radius ◽

Bone Grafts ◽

Vascularized Bone Graft ◽

Daily Life Activities ◽

Carpometacarpal Joints ◽

Effective Treatment Modality ◽

Kienböck Disease ◽

Extensor Compartment ◽

Vascularized Bone

Background: Carpometacarpal joints can be affected by traumatic or degenerative pathology. Although different techniques have been described to treat these conditions, most authors agree that arthrodesis is an effective treatment modality. Vascularized bone grafts of the distal radius have been used to treat carpal conditions, such as scaphoid nonunion or Kiënbock disease, and they have been shown to have several advantages over nonvascularized bone grafts. Methods: We report a case of a carpal boss in a female patient treated with an arthrodesis of the second and third carpometacarpal joints by using the fourth extensor compartment artery vascularized bone graft. Results: At 6 weeks postoperative bone union was achieved. At 2 years follow-up the patient was able to perform daily life activities without pain. Conclusions: The fourth ECA VBG with reverse blood flow from the dorsal intercarpal arch allowed the graft to reach the CMC. A solid fusion was obtained at 6 weeks due to the biological advantage of the VBG.

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