scholarly journals The management of proximal pole scaphoid nonunion with avascular necrosis using 1, 2 intercompartmental supraretinacular arterial bone graft and radial styloidectomy: A midterm outcome study

2018 ◽  
Vol 4 (4) ◽  
pp. 138-143
Author(s):  
Dr. Sibin Surendran ◽  
Dr. Raju Karuppal ◽  
Dr. Harsha T Valoor
Keyword(s):  
Bone Graft ◽  
Avascular Necrosis ◽  
Outcome Study ◽  
Scaphoid Nonunion ◽  
Proximal Pole ◽  
Midterm Outcome

TECHNIQUES FOR VASCULARISED BONE GRAFTING IN SCAPHOID NONUNION

Hand Surgery ◽  
1999 ◽  
Vol 04 (01) ◽  
pp. 21-31 ◽  
Author(s):  
D. J. Wheen ◽  
M. Robinson ◽  
S. Prachaporn ◽  
S. Visvanathan
Keyword(s):  
Internal Fixation ◽  
Bone Graft ◽  
Avascular Necrosis ◽  
Bone Grafting ◽  
Bone Grafts ◽  
Significant Problem ◽  
Scaphoid Nonunion ◽  
Proximal Pole ◽  
Scaphoid Fractures

Nonunion of the scaphoid remains a significant problem in the management of scaphoid fractures. Recurrent persistent nonunion following attempts at internal fixation, and nonunions with sclerosis or avascular necrosis of the proximal pole of the scaphoid are particularly challenging. However, the aims of restoration of scaphoid anatomy and the achievement of union of the scaphoid remain the foundation pillars of scaphoid treatment. In recent years, several techniques for using vascularised bone grafts in the treatment of these difficult problems have been described. This article will review the currently described treatments, provide an overview of our unit experience with these techniques, and also describe a technique for in situ vascularisation of a conventional bone graft.

Dorsal capsular-based vascularized distal radius graft for proximal pole scaphoid nonunion with avascular necrosis

Injury ◽  
2021 ◽  
Author(s):  
Loukia K. Papatheodorou ◽  
Dimitrios V. Papadopoulos ◽  
Micaela M. Graber ◽  
Dean G. Sotereanos
Keyword(s):  
Avascular Necrosis ◽  
Distal Radius ◽  
Scaphoid Nonunion ◽  
Proximal Pole

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 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 Proximal Scaphoid Pole Reconstruction Utilizing Ipsilateral Proximal Hamate Autograft

Hand ◽  
2016 ◽  
Vol 11 (4) ◽  
pp. 495-499 ◽  
Author(s):  
Bassem Elhassan ◽  
Mohamed Noureldin ◽  
Sanjeev Kakar
Keyword(s):  
Avascular Necrosis ◽  
Vascular Supply ◽  
Surgical Reconstruction ◽  
Scaphoid Nonunion ◽  
Proximal Pole ◽  
Secondary Fragmentation ◽  
Scapholunate Instability ◽  
Scaphoid Reconstruction

Background: Fractures of the proximal pole of the scaphoid can be difficult to heal because of its limited vascular supply. Furthermore, nonunion with avascular necrosis and secondary fragmentation makes surgical reconstruction a challenging procedure. Method: We describe a technique and report the outcome of a proximal hamate autograft to treat a proximal pole scaphoid nonunion with avascular necrosis. Results: At 3.5 years post reconstruction, the patient remains asymptomatic with union of his scaphoid reconstruction without any evidence of scapholunate instability. Conclusion: Proximal hamate autograft is a useful technique for addressing proximal pole scaphoid nonunions with avascular necrosis.

scholarly journals Avascular necrosis with non-union of the scaphoid managed with a dorsal pedicled vascularised bone graft of the distal radius – a case report

2021 ◽  
Vol 8 (10) ◽  
pp. 3189
Author(s):  
Surya Rao Rao Venkata Mahipathy ◽  
Alagar Raja Durairaj ◽  
Narayanamurthy Sundaramurthy ◽  
Anand P. Jayachandiran ◽  
Suresh Rajendran
Keyword(s):  
Bone Graft ◽  
Avascular Necrosis ◽  
Bone Remodelling ◽  
Bone Grafts ◽  
Vascular Supply ◽  
Favourable Outcome ◽  
Proximal Pole ◽  
Non Union ◽  
Hand Surgeon ◽  
Vascularised Bone Graft

Avascular necrosis (AVN) of the scaphoid is common following proximal pole fractures due to an arduous retrograde arterial vascular supply and it is a challenge to the hand surgeon. The treatment for scaphoid non-union with avascular necrosis is vascularized or non-vascularized bone grafts. Non vascularised bone grafts (NVBGs) can be categorized as autograft or allograft and cancellous or cortical bone grafts. Vascularised bone grafts promote biological healing and revascularizes ischaemic bone and they are free or pedicled grafts. Pedicled vascularised bone grafts maintain the vascular supply of the donor bone graft and this leads to better bone remodelling, less osteopenia, faster incorporation and better maintenance of bone mass compared to the non-vascularised graft with good clinical and radiological outcomes. In this paper, we have treated avascular necrosis of scaphoid with a pedicled vascularised bone graft based on the 1, 2 intercompartmental supraretinacular artery (1, 2-ICSRA) that resulted in a favourable outcome.

Sign in / Sign up

Export Citation Format

Share Document