A vascularized bone graft harvested from the dorsal base of the third metacarpal bone for the treatment of scaphoid nonunion

Author(s):  
Q. Shen ◽  
C. Liu ◽  
X. Zhang ◽  
Y. Yu ◽  
X. Huang ◽  
...  
2011 ◽  
Vol 16 (6) ◽  
pp. 749-755 ◽  
Author(s):  
Hiroyuki Matsuki ◽  
Shigeharu Uchiyama ◽  
Hiroyuki Kato ◽  
Junichi Ishikawa ◽  
Norimasa Iwasaki ◽  
...  

Hand Surgery ◽  
2015 ◽  
Vol 20 (02) ◽  
pp. 222-227 ◽  
Author(s):  
Steven E.R. Hovius ◽  
Tim de Jong

The scaphoid is the most common fractured bone in the wrist. Despite adequate non-surgical treatment, around 10% to 15% of these fractures will not heal. Untreated scaphoid non-union can cause a scaphoid non-union advance collapse (SNAC), this is a progressive deformity and can cause degenerative changes in the wrist. Surgery is focused on achieving consolidation, pain reduction and a good position of the scaphoid while preventing osteoarthritis in the long-term. Surgery consists of reduction and fixation of the scaphoid with a non-vascularized or vascularized bone graft. An overview of the most used vascularized and non-vascularized bone grafts and their indications are presented.


2002 ◽  
Vol 27 (5) ◽  
pp. 413-416 ◽  
Author(s):  
R. G. STRAW ◽  
T. R. C. DAVIS ◽  
J. J. DIAS

Pedicled vascularized bone grafts (Zaidemberg’s technique) were used to treat 22 established scaphoid fracture nonunions, 16 of which were found to have avascular proximal poles at surgery. After a follow-up of 1–3 years, only six (27%) of the 22 fracture nonunions had united. Only two of the 16 nonunions with avascular proximal poles united, compared with four of the six nonunions with vascular proximal poles. We conclude that this technique of pedicled vascularized bone grafting may not improve the union rate for scaphoid fracture nonunions with avascular proximal pole fragments.


Author(s):  
Young Woo Kwon ◽  
Dong Hwan Kim

Purpose: A vascularized bone graft is an option showing a good result to treat scaphoid nonunion. The analysis of the effects of smoking, which affects vascular and union of fracture, has been limited. We tried to analyze the effect of smoking on the outcomes of vascularized bone graft in scaphoid nonunion through meta-analysis Methods: Two researchers analyzed 923 papers searched for ‘scaphoid AND (vascularized OR vascularised OR flap OR pedicled)’ on MEDLINE and Embase (until November 2020). We selected 31 papers which contain that vascularized bone graft was performed for scaphoid nonunion, and the number or proportion of smokers could be confirmed. Through meta-regression analysis and subgroup analysis, whether the smoker’s rate had an effect on union rate, union period, functional score, imaging evaluation, range of motion, and complications rate was analyzedResults: A significant negative correlation between smoking and bone union rate was confirmed in pedicled vascularized bone grafting, and a significant positive correlation between smoking and bone union duration was confirmed in free vascularized bone grafting. Conclusion: It is necessary to have caution for nonunion when considering pedicled vascularized bone graft in smoking patients with scaphoid nonunion.


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