31 Free Vascularized Medial Femoral Condyle Grafs for Scaphoid Nonunion

The Scaphoid ◽  
2011 ◽  
Keyword(s):  
Femoral Condyle ◽  
Medial Femoral Condyle ◽  
Scaphoid Nonunion

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

scholarly journals The Efficacy of Vascularized Bone Grafts in the Treatment of Scaphoid Nonunions and Kienbock Disease: A Systematic Review in 917 Patients

2018 ◽  
Vol 11 (01) ◽  
pp. 006-013 ◽  
Author(s):  
Andreas Tsantes ◽  
Dimitrios Papadopoulos ◽  
Ioannis Gelalis ◽  
Marios Vekris ◽  
Emilios Pakos ◽  
...  
Keyword(s):  
Femoral Condyle ◽  
Bone Grafts ◽  
Medial Femoral Condyle ◽  
Scaphoid Nonunion ◽  
Kienböck’S Disease ◽  
Kienböck's Disease ◽  
Artery Graft ◽  
Consolidation Rate ◽  
Vascularized Bone ◽  
Kienbock’S Disease

Abstract Background Vascularized bone grafts have become one of the first treatment options for scaphoid nonunions and Kienböck's disease. The aim of this study is to review the current body of the literature regarding the use of four vascularized bone grafts (1,2 ICSRA [1,2 intercompartmental supraretinacular artery] graft, 4+5 ECA [4+5 extracompartmental artery] graft, volar radial graft, and free medial femoral condyle graft) in these pathologies. Patients and Methods A search on MEDLINE and Google Scholar was performed. Exclusion criteria included language other than English, studies with no full text available, case reports, letters, editorials, and review articles. The primary outcomes included consolidation rate of the grafts and time to union regarding scaphoid nonunion, as well as the clinical outcomes (pain, grip strength, range of motion), revascularization of the lunate, and progression of the disease regarding Kienböck's disease. Results A total of 37 articles were included in the study enrolling 917 patients. Regarding scaphoid nonunion, the consolidation rate was 86.3% for the 1,2 ICSRA graft, 93.9% for the volar radial bone graft, and 88.8% for the free medial femoral condyle graft. In patients with Kienböck's disease, progression of the disease was observed in 13% of patients, and grip strength and pain were substantially improved whereas range of motion did not demonstrate statistically significant improvement (p < 0.05). Conclusion Vascularized bone grafts yield successful outcomes in patients with scaphoid nonunions demonstrating a high union rate. In patients with Kienböck's disease, vascularized grafts lead to revascularization of the lunate in most of the cases with concomitant improvement of the clinical parameters.

Free Medial Femoral Condyle Flap for Reconstruction of Scaphoid Nonunion: A Systematic Review

2021 ◽  
Author(s):  
Kiane J. Zhou ◽  
David J. Graham ◽  
David Stewart ◽  
Richard D. Lawson ◽  
Brahman S. Sivakumar
Keyword(s):  
Femoral Condyle ◽  
Operative Management ◽  
Medial Femoral Condyle ◽  
Bony Union ◽  
Complication Rates ◽  
Scaphoid Nonunion ◽  
Union Rate ◽  
Recipient Site ◽  
Major Donor ◽  
Meta Analyses

Abstract Background The free medial femoral condyle (MFC) bone flap is an attractive option for reconstruction of scaphoid nonunion utilizing vascularized bone to augment bony healing, especially in cases of failed prior treatment or osteonecrosis. This review aims to determine the role and reliability of the free MFC flap for treatment of scaphoid nonunion. Methods A search of electronic databases was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Articles examining free MFC bone flaps for treatment of scaphoid nonunion were included for analysis. Outcomes of interest included flap failure, postoperative union rate, time to union, carpal indices, functional outcomes, and complications. Results Twelve articles met the inclusion criteria. A total of 262 patients underwent free MFC flaps for treatment of scaphoid nonunion. The most common site of nonunion was the proximal pole of the scaphoid with 47% of patients receiving prior attempts at operative management. Overall bony union rate was 93.4% with a mean time to union of 15.6 weeks. There were no flap failures reported. Improvements in carpal indices including scapholunate (p < 0.0004), radiolunate (p < 0.004), lateral interscaphoid angles (p < 0.035), and revised carpal ratio height (p < 0.024) were seen postoperatively. Visual analog scale improved postoperatively from 6.5 to 2.3 (p < 0.015). Postoperative complications were observed in 69 cases (26.3%), with 27 patients (10.3%) requiring further operative intervention. However, no major donor or recipient site morbidity was appreciated. Conclusion MFC flaps provide a highly versatile and reliable option for reconstruction of scaphoid nonunion with excellent bony union rates and acceptable complication rates. The present literature suggests that MFC reconstruction of scaphoid nonunion restores radiocarpal anatomy and improves wrist function without causing significant donor or recipient site morbidity.

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.

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