Possible applications of pedicled vascularized bone transplants of the distal radius

Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft für Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft für Mikrochirurgie der Peripheren Nerven und Gefässe : Organ der Vereinigung der Deut
M Sauerbier, Allen T Bishop

Abstract

Reverse-flow pedicle vascularized bone grafts (VBGs) from the distal radius may be used for the surgical treatment of carpal fracture nonunions and avascular necrosis. Such grafts remain viable with quantifiable blood flow as demonstrated in a recent canine experiment. In this paper, the vascular anatomy of the distal radius is demonstrated and the surgical technique of VBG harvest is described. Our indications and results for treatment of scaphoid nonunion and Kienböck's disease are discussed and compared with the current literature. Fifteen patients with scaphoid nonunion and nine patients with Kienböck's disease stage IIIa were treated by reverse-flow pedicled VBG. Range of motion and grip strength were measured postoperatively and compared to the contralateral hand in all patients. An outcome questionnaire was used to measure patient's satisfaction and ADL's in the patients with Kienböck's disease. The radiologic diagnostic was performed with conventional X-rays, trispiral tomograms and MRI. In the scaphoid nonunion group, all patients were male, with an average age of 27.6 years. Five patients had prior attempts of autogenous bone grafting which failed. Six patients had a radiographic suggestion of proximal fragment avascu...Continue Reading

Citations

Jan 9, 2010·Operative Orthopädie und Traumatologie·Michael SauerbierNina Ofer
Sep 22, 2015·Hand Surgery : an International Journal Devoted to Hand and Upper Limb Surgery and Related Research : Journal of the Asia-Pacific Federation of Societies for Surgery of the Hand·Gregory Ian BainLevi Philip Morse
Mar 29, 2016·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·Konstantinos DitsiosAnastasios Christodoulou
Aug 17, 2006·Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery·Lone Kirkeby, Torben Baek Hansen
Oct 14, 2020·Journal of Tissue Engineering and Regenerative Medicine·Tarek IsmailArnaud Scherberich

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