Journal of Hand Surgery (European Volume) · 1997 · 85 citations · 9 references
MedicineOrthopaedic SurgerySurgeryBone GraftingSpine SurgeryVascular SurgeryBone ReconstructionScapular FracturesUpper Extremity ReconstructionVascularized Bone GraftingAvascular Necrosis Of BoneOperative TreatmentOsseous Union After ReconstructionVascularized Bone FlapsVascularized Bone ReconstructionVascularized Scapular Graft
Four patients with chronic nonunion of the scaphoid were treated by a vascularized bone graft based on first dorsal metacarpal artery. The mean duration of the nonunion was 28.5 months (range 12-48 months). There was avascular necrosis in all patients confirmed by magnetic resonance imaging (MRI). None of the patients had previous attempts at surgical reconstruction. Two fractures were localized at the waist one in the distal part and one at the proximal pole. Osseous union of the scaphoid was confirmed by X-ray in all patients in an average of 2.1 months. We recommend this technique for the treatment of established scaphoid pseudoarthrosis with avascular necrosis since it is associated with minimal morbidity and predictable good results.
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