scholarly journals Pronator quadratus pedicled bone graft for scaphoid non-unions

2020 ◽  
Vol 7 (10) ◽  
pp. 3414
Author(s):  
Harsha Vardhan ◽  
Anto Francis
Keyword(s):  
Bone Graft ◽  
Fracture Healing ◽  
Scaphoid Fracture ◽  
Fracture Site ◽  
Vascularized Bone Graft ◽  
Proximal Pole ◽  
Pronator Quadratus ◽  
Scaphoid Fractures ◽  
Fracture Nonunion ◽  
Vascularized Bone

Scaphoid fractures frequently present with nonunion and proximal pole necrosis, the treatment of which is bone grafting. Pronator quadratus pedicled vascularized bone graft is an option especially in the setting of proximal pole necrosis. We describe our experience of managing such scaphoid non-unions using pronator quadratus pedicled vascularized bone graft. Six patients were managed using pronator quadratus pedicled vascularized bone graft following scaphoid fracture nonunion with proximal pole necrosis. All patients had good fracture healing and symptom resolution. Mild deficit in wrist extension was noted in all patients. Pronator quadratus pedicled vascularized bone graft is an attractive option for managing scaphoid nonunion. Lying adjacent to the fracture site, bone can be harvested and transferred without making any other incisions. This procedure introduces another source of blood supply to the fracture site and hence improves fracture healing.

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.

Gadolinium Enhanced Mr Assessment of Proximal Fragment Vascularity in Nonunions after Scaphoid Fracture: Does It Predict the Outcome of Reconstructive Surgery?

2004 ◽  
Vol 29 (5) ◽  
pp. 444-448 ◽  
Author(s):  
A.K. SINGH ◽  
T.R.C. DAVIS ◽  
J.S. DAWSON ◽  
J.A. ONI ◽  
N.D. DOWNING
Keyword(s):  
Internal Fixation ◽  
Reconstructive Surgery ◽  
Scaphoid Fracture ◽  
Proximal Fragment ◽  
Proximal Pole ◽  
Scaphoid Fractures ◽  
Fracture Nonunion ◽  
Fracture Nonunions ◽  
Outcome Of Surgery ◽  
Mr Scanning

This study investigated whether the outcome of bone graft and internal fixation surgery for nonunion of scaphoid fractures could be predicted by gadolinium-enhanced MR assessments of proximal fragment vascularity. Sixteen established scaphoid fracture nonunions underwent gadolinium-enhanced MR scanning before surgical treatment with bone grafting and internal fixation. No relationship was found between MR enhancement and the outcome of surgery. Union was achieved in eight of the 12 nonunions with more than 50% enhancement, and three of the four with less than 50% enhancement, of the proximal pole. Furthermore, union was achieved in both of the nonunions which had less than 25% enhancement of the proximal pole. We conclude that enhanced MR assessments of the vascularity of the proximal fragment of a scaphoid fracture nonunion do not accurately predict the outcome of reconstructive surgery.

scholarly journals Vascularized bone graft in Herbert type D scaphoid fractures

2019 ◽  
Vol 5 (2.3) ◽  
pp. 241-243
Author(s):  
Dr. Varun Goel ◽  
Dr. Neha Bhardwaj ◽  
Dr. Jay Dhariwal ◽  
Dr. Surinder Jaiswal ◽  
Dr. Darshan MS
Keyword(s):  
Bone Graft ◽  
Vascularized Bone Graft ◽  
Scaphoid Fractures ◽  
Type D ◽  
Vascularized Bone

scholarly journals Effect of Screw Length and Geometry on Interfragmentary Compression in a Simulated Proximal Pole Scaphoid Fracture Model

Hand ◽  
2018 ◽  
Vol 15 (3) ◽  
pp. 378-383
Author(s):  
Samik Patel ◽  
Juan M. Giugale ◽  
Richard E. Debski ◽  
John R. Fowler
Keyword(s):  
Analysis Of Variance ◽  
Scaphoid Fracture ◽  
Fracture Site ◽  
Proximal Pole ◽  
Scaphoid Fractures ◽  
Screw Length ◽  
Significant Difference ◽  
Headless Compression Screws ◽  
With Screws ◽  
Interfragmentary Compression

Background: The objective of this study was to determine interfragmentary compression forces based on screw length and geometry for simulated proximal scaphoid fractures. Methods: Sixty-four foam model simulated fractures were stabilized with screws of various length (10 mm, 18 mm, 20 mm, or 24 mm) and geometry (central threadless or fully threaded) across a proximal fracture. Interfragmentary compression was measured at the simulated fracture site upon fixation. An independent sample t test and 1-way analysis of variance were performed to assess differences in interfragmentary compression. Results: Fixation utilizing a 10-mm screw generated significantly less interfragmentary compression than fixation utilizing a 20-mm or 24-mm screw. When accounting for both screw length and geometry, an 18-mm central threadless screw generated greater interfragmentary compression than a 20-mm and 24-mm fully threaded screw; there was no significant difference in compression between an 18-mm and 24-mm central threadless screw. Conclusions: The design of headless compression screws allows for maximal interfragmentary compression at the screw midpoint; we questioned whether a short screw centered on the fracture site resulted in superior compression to a longer, noncentered screw. Our data suggest that centering a small screw (10 mm) along a proximal fracture generates significantly less interfragmentary compression than a longer, noncentered screw. Our results demonstrate that balance between maximizing screw length and centering the screw on the fracture is vital toward maximizing interfragmentary compression for the fixation of proximal third scaphoid fractures.

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

Primary Vascularized Distal Radius Bone Graft for Nonunion of the Scaphoid

2000 ◽  
Vol 25 (3) ◽  
pp. 266-270 ◽  
Author(s):  
C. UERPAIROJKIT ◽  
S. LEECHAVENGVONGS ◽  
K. WITOONCHART
Keyword(s):  
Bone Graft ◽  
Avascular Necrosis ◽  
Distal Radius ◽  
Pinch Strength ◽  
Type I ◽  
Vascularized Bone Graft ◽  
Proximal Pole ◽  
The Mean ◽  
Mean Time ◽  
Vascularized Bone

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.

Scaphoid fracture non-union: a systematic review of surgical treatment using bone graft

2015 ◽  
Vol 41 (5) ◽  
pp. 492-500 ◽  
Author(s):  
D. O. Ferguson ◽  
V. Shanbhag ◽  
H. Hedley ◽  
I. Reichert ◽  
S. Lipscombe ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bone Graft ◽  
Study Design ◽  
Scaphoid Fracture ◽  
Vascularized Bone Graft ◽  
Level Of Evidence ◽  
Data Set ◽  
Non Union ◽  
Quality And Outcomes ◽  
Vascularized Bone

This systematic review assesses the quality and outcomes of published articles concerning bone graft surgery for scaphoid fracture non-union. Searches of the CENTRAL, MEDLINE, EMBASE, CINAHL and AMED databases captured 2710 articles. Each article was screened and 144 met our inclusion criteria. Data regarding source, study design, population, intervention, comparator and outcomes were extracted. There were 5464 scaphoid non-union outcomes within the 144 studies. Mean reported union rates for vascularized and non-vascularized bone graft were 84% and 80%, respectively. Avascular necrosis was diagnosed in several ways and, when present, the vascularized bone graft union rate was 74% compared with 62% with non-vascularized bone graft. Reported union rates vary considerably. These differences may be due to patient factors, fracture factors, treatment factors or study design failures or bias. We recommend that future researchers take into account the deficiencies of previous studies and use the suggested minimum data set in future studies. Level of evidence: II

scholarly journals Pseudarthrosis of the Carpal Scaphoid Treated with Non-Vascularized Corticocancellous Bone Graft

2018 ◽  
Vol 24 (2) ◽  
Author(s):  
Omar Mourafiq ◽  
Valery Kamenan ◽  
Youssef Benyias ◽  
Jalal Boukhriss ◽  
Bouchaib Chefry ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Bone Graft ◽  
Poor Prognosis ◽  
Orthopaedic Surgery ◽  
Plaster Cast ◽  
Military Hospital ◽  
Vascularized Bone Graft ◽  
Non Union ◽  
Scaphoid Fractures ◽  
Vascularized Bone

Objectives: To carry out an epidemiological study and to assess the evolutionary profile of patients with scaphoid non-union treated by anterior non-vascularized corticocancellous bone graft. Introduction: The non-union is a serious complication of carpal scaphoid fractures. Untreated, it leads to instability and osteoarthritis of the carp. The most used technique is that of Matti-Russe employing a corticocancellous graft. Materials and methods: We report in this retrospective study the experience of the department of Orthopaedic Surgery & Traumatology II, Mohamed V Military Hospital, Rabat, in the treatment of non-unions of the carpal scaphoid by anterior non-vascularized corticocancellous graft in nine cases collected between January 2012 and March 2016. We identified six cases of stage IIA and three cases of stage IIB. All our patients were operated by the Matti-Russian technique followed by an immobilization by plaster cast cuff on three months. Results: All our patients achieved a union within an average of three months. The Mayo Wrist score was excellent in 66.6% of cases. Our results were very satisfying in 90% of cases, satisfying in 10%. Conclusion: The treatment of non-unions of the carpal scaphoid without necrosis or osteoarthritis, using anterior non-vascularized bone graft remains the most widely used technique. The presence of initial instability is a factor of poor prognosis, its correction reduces the risk of arthritis.

Sign in / Sign up

Export Citation Format

Share Document