Scaphoid nonunion treated with vascularised bone graft from dorsal radius

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dc.contributor.authorÖzalp T.
dc.contributor.authorÖz Ç.
dc.contributor.authorKale G.
dc.contributor.authorErkan S.
dc.date.accessioned2024-07-22T08:13:36Z
dc.date.available2024-07-22T08:13:36Z
dc.date.issued2015
dc.description.abstractIntroduction The main aim of this retrospective study was to present our experience on scaphoid nonunion treated with vascularised bone graft. Methods Between 2006 and 2012, 58 patients presenting with symptomatic scaphoid nonunion were eligible to participate in this study. Topography of the nonunion included 29 proximal, 25 waist and 4 distal scaphoid nonunions. Vascularised bone graft from distal dorsal radius was used in all cases which were stabilised with the headless cannulated compression screws. Scapholunate angles, Natrass carpal height ratio were evaluated pre and postoperatively. Range of motion of the affected side was compared to that of the contralateral side after the surgery. Results Radiographic union was achieved in 50, out of 58 cases with an average time of 9.9 weeks (range, 6-18 weeks). Out of all the non-united cases, four of them were in proximal, three in the waist and one was in distal scaphoid. In nine proximal nonunions treated by 4 + 5 ECA graft all but one were united. The mean follow up was 21.7 months (12-62 months). The flexion was 91.6%, the extension was 91.5%, the radial deviation was 81.2%, and the ulnar deviation was 89.5% compared to the other side. The grip strength was 93%. Preoperative DASH score was 61.5 diminishing to 28.7 postoperatively. There was no significant change in Natrass carpal height ratio but a slight improvement occurred in scapholunate angles both pre and postoperatively. Conclusion Vascularised bone graft is a good solution for scaphoid nonunion to enhance the healing rate especially in the presence of avascular necrosis. Proximal pole nonunions, humpback deformity and smoking are important negative factors for scaphoid nonunion despite the use of a vascularised bone graft. A trapezoidal wedge graft is necessary for the volar type nonunions with humpback deformity. 1,2 ICSRA offer an advantage with its proximity to scaphoid in all nonunion locations. Nonetheless, 4 + 5 ECA graft is also a good solution for proximal nonunions. © 2015 Elsevier Ltd. All rights reserved.
dc.identifier.DOI-ID10.1016/j.injury.2015.05.032
dc.identifier.issn00201383
dc.identifier.urihttp://akademikarsiv.cbu.edu.tr:4000/handle/123456789/16370
dc.language.isoEnglish
dc.publisherElsevier Ltd
dc.subjectAdolescent
dc.subjectAdult
dc.subjectBone Transplantation
dc.subjectFemale
dc.subjectFollow-Up Studies
dc.subjectFracture Fixation, Internal
dc.subjectFractures, Ununited
dc.subjectHumans
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectRadius
dc.subjectRange of Motion, Articular
dc.subjectRetrospective Studies
dc.subjectRisk Factors
dc.subjectScaphoid Bone
dc.subjectTreatment Outcome
dc.subjectTurkey
dc.subjectadolescent
dc.subjectadult
dc.subjectArticle
dc.subjectavascular necrosis
dc.subjectbone graft
dc.subjectcannulation
dc.subjectcompression screw
dc.subjectcontrolled study
dc.subjectDisabilities of the Arm, Shoulder and Hand (score)
dc.subjectfemale
dc.subjectfollow up
dc.subjectfracture healing
dc.subjectgrip strength
dc.subjecthand radiography
dc.subjecthand surgery
dc.subjecthuman
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectpostoperative period
dc.subjectpreoperative period
dc.subjectpriority journal
dc.subjectproximal row carpectomy
dc.subjectpseudarthrosis
dc.subjectradius
dc.subjectrange of motion
dc.subjectscaphoid bone
dc.subjectscaphoid fracture
dc.subjectscaphoid nonunion
dc.subjectsurgical patient
dc.subjecttopography
dc.subjectvascularized bone graft
dc.subjectbone transplantation
dc.subjectepidemiology
dc.subjectFractures, Ununited
dc.subjectinjuries
dc.subjectjoint characteristics and functions
dc.subjectmiddle aged
dc.subjectosteosynthesis
dc.subjectprocedures
dc.subjectradiography
dc.subjectradius
dc.subjectretrospective study
dc.subjectrisk factor
dc.subjectscaphoid bone
dc.subjecttransplantation
dc.subjecttreatment outcome
dc.subjectTurkey
dc.subjectvascularization
dc.titleScaphoid nonunion treated with vascularised bone graft from dorsal radius
dc.typeArticle

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