Successful treatment of total avascular necrosis in a pediatric scaphoid nonunion with vascularized medial femoral condyle bone graft: Case report

2021 ◽  
Author(s):  
Okan Aslantürk ◽  
Ali Canbay ◽  
Emre Ergen ◽  
Mustafa Karakaplan ◽  
Kadir Ertem
Keyword(s):  
Case Report ◽  
Bone Graft ◽  
Avascular Necrosis ◽  
Successful Treatment ◽  
Femoral Condyle ◽  
Medial Femoral Condyle ◽  
Scaphoid Nonunion

scholarly journals Free Vascularized Medial Femoral Condyle Bone Graft for Scaphoid Nonunion with Poor Prognosis Factors

2021 ◽  
Author(s):  
Sam-Guk Park ◽  
Bum-Jin Shim ◽  
Hyun-Gyu Seok
Keyword(s):  
Prognostic Factors ◽  
Bone Graft ◽  
Avascular Necrosis ◽  
Poor Prognosis ◽  
Femoral Condyle ◽  
Medial Femoral Condyle ◽  
Scaphoid Nonunion ◽  
Prognosis Factors ◽  
Carpal Height

Purpose: Authors attempt to evaluate the clinical and radiographic results of the treatment of scaphoid nonunion with poor prognostic factors with the free vascularized medial femoral condyle bone graft. Methods: We operated on eight patients with avascular necrosis or prolonged nonunion of the scaphoid between January 2016 and July 2019. Wrist motion in terms of flexion, extension, and ulnar and radial deviation, a visual analogue scale (VAS), the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, the modified Mayo wrist score, scapholunate angle, and carpal height index were collected in the clinic setting preoperatively and at the latest follow-up in all patients Results: Eight patients with union achieved correction and maintenance of both scapholunate angle and carpal height index. The VAS pain scores significantly improved from 5.1 preoperatively to 3.3 postoperatively. There was a statistically significant improvement in the average DASH score at the final follow-up. Scapholunate relationships in the reconstructed wrists remained almost unchanged, with average scapholunate angles of 49.7° before surgery and 47.0° at the latest postoperative follow-up. There was no statistical significance between the number of poor prognosis factors and the time to union, but there was a positive correlation.Conclusion: It could help surgeons manage the scaphoid nonunion associated with poor prognostic factors such as avascular necrosis, carpal collapse (posttraumatic arthritis), prolonged nonunion, and failed prior scaphoid nonunion surgery.

Primary medial femoral condyle vascularized bone graft for scaphoid nonunions with carpal collapse and proximal pole avascular necrosis

2018 ◽  
Vol 44 (6) ◽  
pp. 600-606 ◽  
Author(s):  
Kathleen M. Kollitz ◽  
Nicholas Pulos ◽  
Allen T. Bishop ◽  
Alexander Y. Shin
Keyword(s):  
Bone Graft ◽  
Avascular Necrosis ◽  
Femoral Condyle ◽  
Primary Treatment ◽  
Medial Femoral Condyle ◽  
Inclusion Criteria ◽  
Level Of Evidence ◽  
Carpal Collapse ◽  
Time From Injury ◽  
Vascularized Bone

This study aimed to determine the outcome of free vascularized medial femoral condyle bone grafts in the primary treatment of scaphoid nonunions with scaphoid foreshortening or carpal collapse and intraoperatively documented avascular necrosis. Thirty-two patients (28 male, four female) met the inclusion criteria. Median time from injury to surgery was 70 weeks. Thirty of 32 patients healed at a median of 12 weeks. There was significant improvement from preoperative to postoperative lateral intrascaphoid angle, scapholunate angle, and radiolunate angle. Two scaphoids failed to unite; one patient underwent scaphoidectomy and four-corner fusion 15 months postoperatively after suffering a subsequent injury. Another patient underwent 1,2-intercompartmental supraretinacular artery-based vascularized bone grafting at 4 months postoperatively and then scaphoid excision with four-corner fusion 4 years later. The free vascularized medial femoral condyle bone graft restores scaphoid vascularity and architecture while promoting union in a subset of scaphoid nonunions that has historically been a clinical challenge. Level of evidence: IV

Free Vascularized Medial Femoral Condyle Bone Graft After Failed Scaphoid Nonunion Surgery

2018 ◽  
Vol 100 (16) ◽  
pp. 1379-1386 ◽  
Author(s):  
Nicholas Pulos ◽  
Kathleen M. Kollitz ◽  
Allen T. Bishop ◽  
Alexander Y. Shin
Keyword(s):  
Bone Graft ◽  
Femoral Condyle ◽  
Medial Femoral Condyle ◽  
Scaphoid Nonunion

Medial Femoral Condyle Microvascular Bone Transfer as a Treatment for Capitate Avascular Necrosis: Surgical Technique and Case Report

2017 ◽  
Vol 42 (10) ◽  
pp. 841.e1-841.e6 ◽  
Author(s):  
Nikolas H. Kazmers ◽  
Joshua C. Rozell ◽  
Kevin M. Rumball ◽  
Scott H. Kozin ◽  
Dan A. Zlotolow ◽  
...  
Keyword(s):  
Case Report ◽  
Surgical Technique ◽  
Avascular Necrosis ◽  
Femoral Condyle ◽  
Medial Femoral Condyle
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