Free-Vascularized Medial Femoral Condyle Bone Transfer in the Treatment of Scaphoid Nonunions

Jones, David B.; Moran, Steven L.; Bishop, Allen T.; Shin, Alexander Y.

doi:10.1097/prs.0b013e3181d1808c

Cited by 106 publications

(65 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Previous series have reported good results however. 9 Overall, our time to union or union rate have not been as good as those reported in earlier series using the MFC vascularized bone graft (100% union in 3 months).. 13 This may reflect our decision to reserve the technique for nonunions with 1 or more poor prognostic factors rather than for all nonunions. Both of the nonunions in the current study had evidence of AVN, as did one of the delayed unions, but overall there was no clear relationship between the number of poor prognostic factors and failure of union.…”

Section: Discussionmentioning

confidence: 67%

See 1 more Smart Citation

Scaphoid Nonunion With Poor Prognostic Factors

Chaudhry

Uppal

Power

et al. 2016

Hand (New York, N,Y.)

View full text Add to dashboard Cite

Background: To report on the results of free medial femoral condyle (MFC) vascularized bone graft for scaphoid nonunions with 1 or more poor prognostic factors. Methods: We have used the free MFC vascularized bone graft for scaphoid nonunions that have 1 or more factors associated with a poor prognosis. These were, a delay in presentation of over 5 years, a proximal pole nonunion, the presence of avascular necrosis (AVN), or previous nonunion surgery. We used this technique on 20 patients over a 4.5-year period. Results: Our overall union rate was 88.5% (17 of 19 patients), with 1 patient failing to attend for follow-up. Our mean union time was 7 months (2-18). All patients had at least 1 poor prognostic factor and over half had 2 or more. Of those with AVN with or without other factors, the union rate was 85% (11 of 13). There were 2 donor site complications that required a further procedure and 2 patients with residual wrist pain that required a scapho-trapezio-trapezoid joint fusion and a radial styloidectomy, respectively. Both nonunions were offered further surgery, and 1 elected to undergo successful revision surgery. Conclusions: Overall, this technique showed good results, in a subgroup of patients that typically have poorer outcomes, with a low incidence of donor site morbidity. Our union rate compares favorably with other techniques for this difficult subset of patients with 1 or more poor prognostic factors, although results are clearly not as good as those of studies using the MFC graft for all scaphoid nonunions. We continue to reserve this technique for nonunions with 1 or more poor prognostic factors, and we believe that this technique should at least be considered in these patients.

show abstract

Section: Discussionmentioning

confidence: 67%

“…13 The 2 patients who had a prolonged time to union at the proximal interface of the graft, as well as the 2 nonunions that had AVN of the proximal pole, may have been suitable candidates for osteochondral grafts.…”

Section: Discussionmentioning

confidence: 99%

Scaphoid Nonunion With Poor Prognostic Factors

Chaudhry

Uppal

Power

et al. 2016

Hand (New York, N,Y.)

View full text Add to dashboard Cite

show abstract

“…34 Twelve nonunions, 9 of which had failed prior surgical treatment, were treated with a free vascularized MFC graft a mean of 20 months (range, 4 -36 mo) from the time of injury. All patients went on to union at a mean of 13 weeks (range, 6 -36 wk).…”

Section: Medial Femoral Condyle Graftmentioning

confidence: 99%

Vascularized Bone Grafts for Scaphoid Nonunions

Jones

Rhee

Shin

2012

The Journal of Hand Surgery

View full text Add to dashboard Cite

“…Jones et al [22] erzielten beim Einsatz des distal gestielten dorsalen Radiusspans eine Heilungsrate von 71%. Fraglich ist jedoch, wie es zu diesen bedeutenden Unterschieden gekommen ist.…”

Section: Diskussionunclassified

“…Vorrangig genannt wurden Gründe, wie der Nikotinabusus des Patienten, die ausgedehnte avaskuläre Knochennekrose und v. a. erschwerte präoperative Ausgangsbedingungen, wie der bereits eingetretene karpale Kollaps. Fast 100%ige Heilungsraten beschrieben Jones et al [22], die beim Vorliegen eines karpalen Kollaps nun stets direkt auf ein größeres Knochentransplantat, wie den freien vaskularisierten Femurspan, zurückgriffen. Sie beziehen den erzielten operativen Erfolg auf die nun optimale Rekonstruktion der Architektur des Skaphoids, um einen physiologischen skapholunären Winkel wiederherstellen zu können.…”

Section: Diskussionunclassified