scholarly journals The Effect of Smoking on the Outcomes of Vascularized Bone Graft Surgery in Scaphoid Nonunion through Meta-analysis

2021 ◽  
Author(s):  
Young Woo Kwon ◽  
Dong Hwan Kim
Keyword(s):  
Bone Graft ◽  
Bone Grafting ◽  
Meta Analysis ◽  
Bone Union ◽  
Functional Score ◽  
Vascularized Bone Graft ◽  
Scaphoid Nonunion ◽  
Union Rate ◽  
Imaging Evaluation ◽  
Vascularized Bone

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.

Scaphoid Nonunion: Treatment with a Pedicled Vascularized Bone Graft Based on the 1,2 Intercompartmental Supraretinacular Branch of the Radial Artery

2002 ◽  
Vol 27 (5) ◽  
pp. 413-416 ◽  
Author(s):  
R. G. STRAW ◽  
T. R. C. DAVIS ◽  
J. J. DIAS
Keyword(s):  
Bone Graft ◽  
Bone Grafting ◽  
Scaphoid Fracture ◽  
Vascularized Bone Graft ◽  
Scaphoid Nonunion ◽  
Proximal Pole ◽  
Union Rate ◽  
Fracture Nonunions ◽  
Vascularized Bone

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.

scholarly journals Scaphoid Nonunion With Poor Prognostic Factors

Hand ◽  
2016 ◽  
Vol 12 (2) ◽  
pp. 135-139 ◽  
Author(s):  
Tahseen Chaudhry ◽  
Lauren Uppal ◽  
Dominic Power ◽  
Michael Craigen ◽  
Simon Tan
Keyword(s):  
Prognostic Factors ◽  
Bone Graft ◽  
Femoral Condyle ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Vascularized Bone Graft ◽  
Union Rate ◽  
Poor Prognostic Factor ◽  
Low Incidence ◽  
Vascularized Bone

Background: To report on the results of free medial femoral condyle (MFC) vascularized bone graft for scaphoid nonunions with 1 or more poor prognostic factors. Methods: We have used the free MFC vascularized bone graft for scaphoid nonunions that have 1 or more factors associated with a poor prognosis. These were, a delay in presentation of over 5 years, a proximal pole nonunion, the presence of avascular necrosis (AVN), or previous nonunion surgery. We used this technique on 20 patients over a 4.5-year period. Results: Our overall union rate was 88.5% (17 of 19 patients), with 1 patient failing to attend for follow-up. Our mean union time was 7 months (2-18). All patients had at least 1 poor prognostic factor and over half had 2 or more. Of those with AVN with or without other factors, the union rate was 85% (11 of 13). There were 2 donor site complications that required a further procedure and 2 patients with residual wrist pain that required a scapho-trapezio-trapezoid joint fusion and a radial styloidectomy, respectively. Both nonunions were offered further surgery, and 1 elected to undergo successful revision surgery. Conclusions: Overall, this technique showed good results, in a subgroup of patients that typically have poorer outcomes, with a low incidence of donor site morbidity. Our union rate compares favorably with other techniques for this difficult subset of patients with 1 or more poor prognostic factors, although results are clearly not as good as those of studies using the MFC graft for all scaphoid nonunions. We continue to reserve this technique for nonunions with 1 or more poor prognostic factors, and we believe that this technique should at least be considered in these patients.

Non-vascularized bone graft with Herbert-type screw fixation for proximal pole scaphoid nonunion

2011 ◽  
Vol 16 (6) ◽  
pp. 749-755 ◽  
Author(s):  
Hiroyuki Matsuki ◽  
Shigeharu Uchiyama ◽  
Hiroyuki Kato ◽  
Junichi Ishikawa ◽  
Norimasa Iwasaki ◽  
...  
Keyword(s):  
Bone Graft ◽  
Screw Fixation ◽  
Vascularized Bone Graft ◽  
Scaphoid Nonunion ◽  
Proximal Pole ◽  
Vascularized Bone

Bone Grafts for Scaphoid Nonunion: An Overview

Hand Surgery ◽  
2015 ◽  
Vol 20 (02) ◽  
pp. 222-227 ◽  
Author(s):  
Steven E.R. Hovius ◽  
Tim de Jong
Keyword(s):  
Surgical Treatment ◽  
Bone Graft ◽  
Bone Grafts ◽  
Good Position ◽  
Vascularized Bone Graft ◽  
Scaphoid Nonunion ◽  
Non Union ◽  
Non Surgical Treatment ◽  
Vascularized Bone

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.

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