scholarly journals 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 ◽  
2016 ◽  
Vol 12 (5) ◽  
pp. NP88-NP91 ◽  
Author(s):  
Jorge G. Boretto ◽  
David Fernandez-Fernandez ◽  
Gerardo Gallucci ◽  
Pablo De Carli

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.

Hand ◽  
2015 ◽  
Vol 10 (3) ◽  
pp. 454-460
Author(s):  
Sérgio Augusto Machado Da Gama ◽  
Marcelo Rosa De Rezende ◽  
Samuel Ribak

2000 ◽  
Vol 25 (3) ◽  
pp. 266-270 ◽  
Author(s):  
C. UERPAIROJKIT ◽  
S. LEECHAVENGVONGS ◽  
K. WITOONCHART

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.


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.


2008 ◽  
Vol 129 (2) ◽  
pp. 171-175 ◽  
Author(s):  
Taçkin Özalp ◽  
Huseyin Serhat Yercan ◽  
Guvenir Okçu

2013 ◽  
Vol 38 (5) ◽  
pp. 904-908 ◽  
Author(s):  
Hiroyoshi Fujiwara ◽  
Ryo Oda ◽  
Shinsuke Morisaki ◽  
Kazuya Ikoma ◽  
Toshikazu Kubo

10.15417/763 ◽  
2018 ◽  
Vol 83 (1) ◽  
pp. 31
Author(s):  
Ezequiel Ernesto Zaidenberg ◽  
Ezequiel Martinez ◽  
Martin Pastrana ◽  
Fernando Juarez Cesca ◽  
Federico Olazarri ◽  
...  

<p><strong>Introducción</strong></p><p><strong></strong>El 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.</p><p> </p><p><strong>Materiales y Métodos</strong></p><p><strong></strong>Se 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.</p><p> </p><p><strong>Resultados</strong></p><p><strong></strong>Siete 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 &gt; 100° en 5 pacientes y entre 50° - 100° en  2 pacientes. <strong></strong></p><p><strong> </strong></p><p><strong>Conclusión</strong></p><p><strong></strong>El injerto óseo vascularizado pediculado del radio distal es una alternativa efectiva para el tratamiento de la pseudoartrosis de cubito.</p>


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