Vascularized bone graft for scaphoid nonunions

Techniques in Hand & Upper Extremity Surgery
Alexander D Mih

Abstract

Scaphoid fracture nonunion remains a challenging problem that may persist despite traditional methods of bone grafting and internal fixation. The alteration of wrist mechanics created by nonunion as well as the development of avascular necrosis leads to degenerative change of the radiocarpal joint accompanied by loss of motion and pain. The use of a vascularized bone graft has the theoretical benefit of increased blood flow that exceeds that of nonvascularized grafts. Numerous sources of vascularized bone graft have been described, including those from remote sites as well as from the carpus and distal radius. Knowledge of the blood supply to the distal radius has allowed for development of several vascularized bone graft harvest sites. The results of vascularized bone grafting from the distal radius have been encouraging, with numerous authors reporting the successful treatment of scaphoid nonunions.

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Citations

May 29, 2009·Hand : Official Journal of the American Association for Hand Surgery·Claudia LamasPau Forcada
Aug 14, 2012·Hand Clinics·Mark R BelskyDavid E Ruchelsman

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