Further Experience with the Index Metacarpal Vascularized Bone Graft

Mathoulin, Christophe; Brunelli, F.

doi:10.1016/s0266-7681(98)80048-x

Cited by 88 publications

(59 citation statements)

References 6 publications

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“…When vascularized bone grafts other than the 1,2-ICSRA pedicled grafts are used a history of prior surgery also has been reported to have no effect on surgical outcome. [22][23][24][25][26][27] In 2002 Straw et al 12 analyzed the efficacy of vascularized bone grafts from the dorsal distal radius for scaphoid nonunions. They reported a 27% union rate in their series of 22 scaphoid nonunions.…”

Section: Discussionmentioning

confidence: 99%

The Outcomes and Complications of 1,2-Intercompartmental Supraretinacular Artery Pedicled Vascularized Bone Grafting of Scaphoid Nonunions

Chang

Bishop

Moran

et al. 2006

The Journal of Hand Surgery

251

184

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Section: Discussionmentioning

confidence: 99%

The Outcomes and Complications of 1,2-Intercompartmental Supraretinacular Artery Pedicled Vascularized Bone Grafting of Scaphoid Nonunions

Chang

Bishop

Moran

et al. 2006

The Journal of Hand Surgery

251

184

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“…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. 2a).…”

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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“…There were 21 males and 7 females, and average age was 32 years. We used vascularized bone grafts from three different donor sites: the extensor fourth and fifth compartmental distal radius 29,31,32,40 in 8 patients, the first and second intercompartmental distal radius 41,42 in 12 patients, and the second dorsal metacarpal neck [43][44][45] in 8 patients. Selection of the donor site was according to the surgeon's preference (►Figs.…”

Section: Methodsmentioning

confidence: 99%

Vascularized Bone Grafts from the Dorsal Wrist for the Treatment of Kienböck Disease

et al. 2016

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Previous literatures described various methods of treatment for Kienböck disease depending on the patient characteristics, the severity of the symptom, and radiological staging. 1-8 Treatment options range from conservative measurements to surgical interventions. 9-12 Several authors advocated a biomechanical approach to reduce load transmission on the necrotic lunate, [13][14][15][16][17][18][19] and good clinical results have been reported in joint leveling procedures such as radial shortening or ulnar lengthening 20-22 and in radial or ulnar wedge osteotomy. 23,24 Hori et al 25 introduced a biological approach of revascularization for necrotic bones based on their experimental results. Since then, there have been several donor sites available for vascularized bone graft in the treatment of AbstractPurpose The objective of this article is to evaluate functional and radiological outcomes of vascularized bone grafts for stage 2 and 3 Kienböck disease. The outcomes of three different donor sites via dorsal approach of the wrist were compared. Pearls and pitfalls in surgical technique were discussed. Methods There were 28 patients who underwent vascularized bone grafts, including the extensor fourth and fifth compartmental artery graft of distal radius in 8 patients, the first and second supraretinacular intercompartmental artery graft of distal radius in 12 patients, and the second dorsal metacarpal neck graft in 8 patients. Average age was 32 years, and radiological grading according to Lichtman classification was stage 2 in 8 patients, stage 3A in 10 patients, and stage 3B in 10 patients. Temporary pinning fixing the midcarpal joint was conducted for 10 weeks postoperatively. Results Follow-up periods averaged 70 months. Pain reduced in 27 patients, and visual analog scale for pain of pre-and postoperative level averaged 59 and 18. Range of wrist flexion and extension motion improved from 87 to 117 degrees, and average grip strength improved from 21 kg preoperatively to 33 kg postoperatively. Carpal height ratio had almost no change from 0.52 to 0.53. Fragmentation of necrotic bone healed in 7 of the 14 cases. Comparative analyses of functional and radiological outcomes between three donor sites found no significant difference. Conclusion Three different vascularized bone grafts from the dorsal wrist and hand area demonstrated favorable and comparable functional outcomes. It was technically important to elevate vascular bundle with surrounding retinaculum or fascia, to include sufficient periosteum, and to insert the vascularized bone as the cortex aligned longitudinally.

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Further Experience with the Index Metacarpal Vascularized Bone Graft

Cited by 88 publications

References 6 publications

The Outcomes and Complications of 1,2-Intercompartmental Supraretinacular Artery Pedicled Vascularized Bone Grafting of Scaphoid Nonunions

The Outcomes and Complications of 1,2-Intercompartmental Supraretinacular Artery Pedicled Vascularized Bone Grafting of Scaphoid Nonunions

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

Vascularized Bone Grafts from the Dorsal Wrist for the Treatment of Kienböck Disease

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