A Capsular-Based Vascularized Distal Radius Graft for Proximal Pole Scaphoid Pseudarthrosis

Sotereanos, Dean G.; Darlis, N.A.; Dailiana, Zoe; Sarris, Ioannis; Malizos, Konstantinos N.

doi:10.1016/j.jhsa.2006.01.005

Cited by 81 publications

(54 citation statements)

References 40 publications

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“…The graft is generally used for Kienbö ck's disease. Sotereanos et al [29] proposed a capsular based distal radius graft vascularised by the fourth extensor compartment artery for proximal pole nonunions. 10 patients from 13 went on to heal.…”

Section: Discussionmentioning

confidence: 99%

Scaphoid nonunion treated with vascularised bone graft from dorsal radius

Özalp

Öz

Kale

et al. 2015

Injury

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Section: Discussionmentioning

confidence: 99%

Scaphoid nonunion treated with vascularised bone graft from dorsal radius

Özalp

Öz

Kale

et al. 2015

Injury

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“…[7] Chang ve ark., [18] 50 hastanın tedavisinde 1,2 ICSRA (intrakompartmental supraretinaküler arter) vaskülarize kemik grefti kullanımı ile ilgili deneyimlerinde başarısız tedavi ile önemli derecede ilişkisi olan faktörlerin; sigara içme, yaşlılık, avasküler nekroz gelişimi, tespit yetmezliği ve kadın cinsiyet olduğunu belirtmişlerdir. Sotereanos ve ark., [19] yaptıkları çalışmada, proksimal kutuptaki avaskülariteyi MRG, patoloji ya da proksimal kutupta ameliyat sırası kanama olmayışı ile ortaya koymuşlar ve vaskülarize greftleme ile %77 ve %85 oranında kaynama bildirmişlerdir. Dailiana ve ark., [20] radius vaskülarize grefti ile tedavi edilen dokuz hastada mükemmel sonuç bildirmişlerdir.…”

Section: Discussionunclassified

Is nonvascularized autografting in the proximal scaphoid nonunions ineffective?

Pişkin

Çıraklı

Erdoğan

et al. 2014

Eklem Hastalik Cerrahisi

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Amaç: Bu çalışmada nonvaskülarize kemik grefti ve vida tespiti ile proksimal skafoidin kaynamama tedavisinin sonuçları değerlendirildi. Hastalar ve yöntemler: Kliniğimizde proksimal bölge skafoid kaynamaması nedeniyle ameliyat edilen ve en az bir yıl süre ile takibi yapılan 13 hasta değerlendirildi. El bilek hareketleri standart gonyometre ve kas gücü el dinamometresi ile ölçüldü. Kaynamama radyolojik olarak Schernberg sınıflamasına göre, fonksiyonel değerlendir-me ise Herbert-Fisher derecelendirme sistemi ve Mayo Kliniği modifiye el bileği skorlama sistemine göre sınıf-landırıldı. Bulgular: Ortalama takip süresi 14 ay (dağılım, 12-40 ay) idi. On üç hastadan sekizinde (%61.5) tam kaynama gözlendi. Ortalama kaynama süresi 16 hafta (dağılım, 12-40) idi. Tam kaynama olanların el bileği hareketlerinde sağlam ele göre %10'dan fazla fonksiyon kaybı gözlenmedi. Ameliyat sonrası kavrama gücü ortalaması 37.3±3.0 kg idi. Herbert-Fisher sınıflamasına göre mükemmel ve iyi sonuç oranı %61.5, orta ve kötü sonuç oranı %38.5 idi ve ortalama Mayo skoru ise 80±13 idi. Sonuç: Çalışmamızda proksimal skafoid kaynamamaları için nonvaskülarize otogreftleme ve vida tespiti ile tedavi edilen hastalarda tatminkar sonuçlar elde edilemedi. Açık cerrahi ve greftleme işleminin, skafoid kemiğin vasküler beslenmesi üzerine olan olumsuz etkileri nedeniyle greftlemenin seçilmiş olgularda uygulanması gerektiğini düşünüyoruz.Anahtar sözcükler: Kemik grefti; kırık; kaynamama; skafoid; vaskü-larize kemik grefti. Objectives:In this study, we aimed to evaluate the results of proximal scaphoid nonunion treated with nonvascularized bone grafting and screw fixation. Patients and methods: Thirteen patients who were treated surgically for proximal scaphoid nonunion with a minimum of one-year follow-up in our clinic were evaluated. Wrist movements were measured by standard goniometry and muscle strength by hand dynamometry. Nonunion was classified radiologically according to the Schernberg classification, while functional assessment was performed based on the Herbert-Fisher Grading System and the Mayo Clinic Modified Wrist Scoring System. Results: The mean follow-up period was 14 months (range, 12 to 40 months). Full union was observed in eight of 13 patients (61.5%). The mean time to union was 16 (range, 12 to 40) weeks. There was no loss of function of more than 10% compared to the healthy hand in the cases with full union. Postoperative mean grip strength was 37.3±3.0 kg. The rates of excellent and good results were 61.5%, moderate and poor results were 38.5% according to the Herbert-Fisher classification and the mean Mayo score was 80±13. Conclusion: We obtained no satisfactory results in patients treated with nonvascularized bone grafting and screw fixation for proximal scaphoid nonunions. We suggest that grafting should be carried out in selected cases due to the adverse effects of open techniques and bone grafting on vascularity of scaphoid bone.

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“…1a-1d). Alternatively, capsular bone grafts from the distal radius 20 and bone grafts based on the ulnar artery 21 have been described for the treatment of scaphoid nonunions as well as bone grafts from the palmar aspect of the radius based on pronator quadratus fibers. 22,23 Grafts pedicled on the first and second dorsal metacarpal artery have an arc of rotation that may reach the scaphoid, without crossing the radiocarpal joint 24,25 (Fig.…”

Section: Discussionmentioning

confidence: 99%

Donor sites for pedicled skeletal grafts of the hand, wrist, and forearm

Dailiana¹,

Malizos²,

Varitimidis³

et al. 2009

Microsurgery

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Pedicled bone and periosteal grafts provide successful reconstruction of skeletal problems of the distal radius, wrist, and hand. The purpose of this study was to evaluate the available alternatives and to propose the most suitable skeletal grafts for the reconstruction of the distal radius, and the carpal and hand bones. The alternative donor sites (dorsal and palmar distal radius, and metacarpals), their pedicles, and the potential coverage area in relation to specific wrist and hand pathology were determined in the cadaveric dissections. In the clinical setting, 75 pedicled grafts were used for the treatment of scaphoid nonunions (62 cases), lunate necrosis (8 cases), reconstruction of the metacarpal defects (2 cases), and wrist fusions (3 cases). All alternatives have the advantage of a single approach that may be performed under tourniquet control, from the same team. Among the available alternatives, surgeon's familiarity plays the most important role for the final selection of the graft.

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A Capsular-Based Vascularized Distal Radius Graft for Proximal Pole Scaphoid Pseudarthrosis

Cited by 81 publications

References 40 publications

Scaphoid nonunion treated with vascularised bone graft from dorsal radius

Scaphoid nonunion treated with vascularised bone graft from dorsal radius

Is nonvascularized autografting in the proximal scaphoid nonunions ineffective?

Donor sites for pedicled skeletal grafts of the hand, wrist, and forearm

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