Non-union of the scaphoid. Revascularization of the proximal pole with implantation of a vascular bundle and bone-grafting.

1995 ◽  
Vol 77 (6) ◽  
pp. 883-893 ◽  
Author(s):  
D L Fernandez ◽  
S Eggli
Keyword(s):  
Vascular Bundle ◽  
Bone Grafting ◽  
Proximal Pole ◽  
Non Union

scholarly journals The Outcome of Using a Jamshidi Biopsy Trocar Needle in a Novel Technique for Bone Grafting in Percutaneous Internal Fixation of Scaphoid Non-Union

2018 ◽  
Vol 6 (3) ◽  
pp. 506-510
Author(s):  
Syed Bokhari ◽  
Saifullah Hadi ◽  
Fahad Hossain ◽  
Bernd Ketzer
Keyword(s):  
Internal Fixation ◽  
Distal Radius ◽  
Bone Grafting ◽  
Proximal Pole ◽  
Union Rate ◽  
Non Union ◽  
Novel Technique ◽  
Grafting Technique ◽  
Percutaneous Internal Fixation ◽  
Time From Injury

INTRODUCTION: We report the outcome of using a novel technique of minimally invasive internal fixation and distal radius bone grafting using the Jamishidi Trephine needle and biopsy/graft capture device.METHODS: The technique utilises a 8 mm incision at the distal pole of the scaphoid. The non-union is excavated using the standard Acutrak drill. An 8 gauge Jamshidi trephine needle is used to harvest bone graft from the distal radius which is impacted into the scaphoid and fixed with an Acutrak screw. Fifteen patients were available for retrospective review, 14 male, age mean 29.5 (15-56). Average time from injury to surgery was 167 days (45-72). Fractures classified according to Herbert giving 7 D1 and 8 D2 fractures, 14 waist and 1 proximal pole fractures, all of which had no humpback deformity.RESULTS: Sixty-six percentages of the fractures went onto unite, 4/7 D1 and 6/8 D2 united (p > 0.05). Seventy-five percentages of fracture that had surgery in less than 3 months from time of injury went onto unite, whereas only 63% united in patients who had surgery later than 3 months (p > 0.05). DASH outcome for all patients improved from 86 down to 32 (p < 0.05). With those that united going down from 90 to 6. Those that did not unite went from 81 to 61.CONCLUSION: The Jamshidi bone grafting technique shows comparable results (union rate 66%) to other techniques published in the literature (27-100%) providing the surgeon with an alternative and less demanding procedure than open scaphoid non-union surgery.

Failure of Surgery for Scaphoid Non-Union is Associated with Smoking

2006 ◽  
Vol 31 (3) ◽  
pp. 252-255 ◽  
Author(s):  
C. P. LITTLE ◽  
B. J. BURSTON ◽  
J. HOPKINSON-WOOLLEY ◽  
P. BURGE
Keyword(s):  
Bone Grafting ◽  
Smoking Prevalence ◽  
Screw Fixation ◽  
Delayed Union ◽  
Proximal Pole ◽  
Non Union ◽  
Scaphoid Fractures ◽  
The Uk ◽  
Vascularized Bone

Scaphoid fractures predominantly affect young men, in whom the UK smoking prevalence approaches 40%. We examined the association between smoking and failure of non-vascularized bone grafting and screw fixation for scaphoid non-union and delayed union in a retrospective cohort study. Adequate follow-up was obtained in 64 of 87 patients treated (74%). Union was defined as the presence of trabecular continuity on at least two films from a four-view radiographic series. Union was achieved in 47 of 64 cases. Seventeen were smokers. Thirteen of the 17 patients with non-union were smokers (relative risk 3.7; 95% CI: 1.3–10.1, p = 0.005). Proximal pole fractures, long injury-grafting interval and non-compliance were not more frequent in smokers than non-smokers. Smoking is strongly associated with failure of union after screw fixation and non-vascularized bone grafting of the scaphoid. Smokers should be advised to avoid smoking pre-operatively and during the healing period.

Vascularised Bone Grafting in the Management of Scaphoid Non-Union – A Review of 34 Cases

2008 ◽  
Vol 33 (5) ◽  
pp. 628-631 ◽  
Author(s):  
A. K. KAPOOR ◽  
N. W. THOMPSON ◽  
I. RAFIQ ◽  
M. J. HAYTON ◽  
J. STILLWELL ◽  
...  
Keyword(s):  
Bone Grafting ◽  
Statistical Significance ◽  
Dominant Hand ◽  
Proximal Pole ◽  
Non Union ◽  
Risk Of Failure

We reviewed the outcomes of 34 patients who had undergone vascularised bone grafting for a chronic scaphoid non-union. Mean age was 27 years (range 16–46 years). The dominant hand was involved in 17 cases. Eleven patients were smokers. In 18 cases the fracture involved the proximal and in 16 cases the middle third of the scaphoid. In 26 patients the proximal scaphoid fragment was deemed avascular. Sixteen patients had previously undergone scaphoid fixation and non-vascularised bone grafting. At a follow-up of 1 to 3 years (mean 1.6 years), 15 of the 34 scaphoid non-unions had united. Injury to the dominant hand and duration of the non-union significantly increased the risk of failure. Persistent non-union was more common in proximal third fractures and in the presence of an avascular proximal pole but these findings did not reach statistical significance.

scholarly journals Osteogenic protein-1 (BMP-7) accelerates healing of scaphoid non-union with proximal pole sclerosis

2006 ◽  
Vol 30 (2) ◽  
pp. 128-134 ◽  
Author(s):  
R. Bilic ◽  
P. Simic ◽  
M. Jelic ◽  
R. Stern-Padovan ◽  
D. Dodig ◽  
...  
Keyword(s):  
Proximal Pole ◽  
Non Union ◽  
Osteogenic Protein

scholarly journals Locking compression plate in humeral shaft nonunion: a retrospective study of 18 cases

2016 ◽  
Vol 2 (3) ◽  
pp. 86
Author(s):  
Rajesh Govindasamy ◽  
Ramkumar Gnanasundaram ◽  
Saravanan Kasirajan ◽  
Fawas Thonikadavath ◽  
Jeff Walter Rajadurai
Keyword(s):  
Bone Grafting ◽  
Locking Compression Plate ◽  
Humeral Shaft ◽  
Radial Nerve Palsy ◽  
Functional Evaluation ◽  
Postoperative Function ◽  
Non Union ◽  
Humeral Shaft Nonunion ◽  
Compression Plate ◽  
The Mean

<p class="abstract"><strong>Background:</strong> Humeral shaft nonunions are frequently seen in Orthopaedic practice. Osteosynthesis with bone grafting is the treatment of choice. Locking compression plate (LCP) is the latest implant used in treating them. We retrospectively evaluated the outcome of use of LCP in humeral shaft non-union resulted by both conservative management and following failed internal fixations.</p><p class="abstract"><strong>Methods:</strong> Eighteen patients with nonunion of humeral shaft in which ten were treated by traditional bone setters and eight followed by failed internal fixation were included in these study. The mean duration of nonunion was 18.3 months (range 8-22).  The mean follow up period was 18 months (range 12-26). The mean age of patients was 44.4 years (range 22-60). All patients underwent osteosynthesis with LCP and autologoous cortico-cancellous iliac crest graft. The outcome measures include radiographic assessment of fracture union and preoperative and postoperative function using modified constant and murley scoring system.<strong></strong></p><p class="abstract"><strong>Results:</strong> All fractures united following osteosyntesis average time for union was15 weeks (range 10-24). We did not have any delayed union or non-union. The complications were superficial infection (n=1) and wound haematoma (n=1).Three patients with preoperative radial nerve palsy recovered at the end of four months. Functional evaluation using constant-murley score showed excellent result in 14, good in 3 and fair in 1. We did not have any poor results.</p><strong>Conclusions:</strong> LCP with cancellous bone grafting is a safe reliable option for all forms of humeral shaft nonunion. We recommend it.

Management of clavicular non-union with plate fixation and bone grafting

2013 ◽  
Vol 3 (1) ◽  
pp. 49 ◽  
Author(s):  
MazharuddinA Khan ◽  
SujitkumarR Vakati
Keyword(s):  
Bone Grafting ◽  
Plate Fixation ◽  
Non Union

Orthopaedic management of congenital pseudarthrosis of the tibia

2021 ◽  
pp. 655-660
Author(s):  
Fergal Monsell
Keyword(s):  
Bone Grafting ◽  
Fracture Site ◽  
Important Condition ◽  
Non Union ◽  
Congenital Pseudarthrosis ◽  
Vascularized Fibula ◽  
Affected Tissue

Congenital pseudoarthrosis of the tibia is an uncommon but important condition, often associated with neurofibromatosis, in which the tibia has a region of abnormal bone prone to fracture and subsequent non-union with a fibrocartilaginous pseudoarthrosis forming at the fracture site. The limb is prone to malalignment and distal deformity. Management requires correction and stabilization of the deformity with excision of the affected tissue of the tibia and reconstruction either with bone grafting, transport, or transfer of vascularized fibula.

Onlay Fibular Bone Grafting in Treatment of Tibial Fracture Non-Union

1978 ◽  
Vol &NA; (130) ◽  
pp. 247???253
Author(s):  
WILLIAM J. DAWSON ◽  
NEWTON C. MEAD ◽  
HOWARD J. SWEENEY ◽  
MICHAEL F. SCHAFER
Keyword(s):  
Bone Grafting ◽  
Tibial Fracture ◽  
Non Union
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