Management of scaphoid nonunion with avascular necrosis using 1,2 intercompartmental supraretinacular arterial bone graft

Dehghani, Mohamad; Soltanmohamadi, Mohamad; Tahririan, Mohammad Ali; Moezi, Mehdi M.; Daneshpajouhnejad, Parnaz; Zarezadeh, Abolghasem

doi:10.4103/2277-9175.140094

Cited by 9 publications

(4 citation statements)

References 10 publications

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“…Numerous bone grafting techniques have been proposed for the treatment of SN. The differences between these techniques include the bone graft harvest site, fixation method and using vascularized bone graft (VBG) or non-vascularized bone graft (NVBG) [ 14 – 18 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical and functional outcomes of vascularized bone graft in the treatment of scaphoid non-union

Rahimnia

Mobasher-Jannat

2018

PLoS ONE

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IntroductionScaphoid non-union is a challenging and complex problem. Various methods have been proposed for the management of patients with scaphoid non-union and to reduce the risk of complications. In this study, our aim was to evaluate the clinical and functional outcomes of using a vascularized bone graft in the treatment of scaphoid non-union.MethodsPatients with scaphoid non-union who underwent 1,2 intercompartmental supraretinacular artery pedicled vascularized bone graft between January 2005 and January 2011 were enrolled. The parameters assessed included clinical and functional outcomes, radiological measures, and potential risk factors.ResultsForty-one patients were finally included. Thirty patients achieved union (73%) and 11 did not. Smoking was a significant risk factor for non-union after the surgery. In patients who achieved union, grip strength and radioulnar abduction were greater in comparison to that in patients who did not achieve union. Functional measures, including the Disabilities of Arm and Shoulder score and the Modified Mayo Wrist Score, improved in patients with scaphoid union. The scaphoid length also improved significantly postoperatively in these patients.ConclusionSurgical treatment of scaphoid non-union using vascularized bone graft led to a high union rate with good clinical and functional outcomes. Smoking is a risk factor for non-union, even with the use of a vascularized bone graft. Avascular necrosis was not associated with an increased risk for non-union.

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Section: Introductionmentioning

confidence: 99%

Clinical and functional outcomes of vascularized bone graft in the treatment of scaphoid non-union

Rahimnia

Mobasher-Jannat

2018

PLoS ONE

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“…Statistical analyses were performed using the paired t-test. [18] A P value of <.05 was considered statically significant.…”

Section: Methodsmentioning

confidence: 99%

Arthroscopy-assisted bone grafting for the treatment of SNAC stage I without radial styloidectomy

Lee

Jung

2022

Medicine

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To report the clinical and radiological outcomes of arthroscopic bone grafting and percutaneous K-wire fixation without radial styloidectomy in patients with scaphoid nonunion advanced collapse (SNAC). We retrospectively analyzed the records of 15 patients with SNAC who were treated with arthroscopic bone grafting and percutaneous K-wire fixation and subsequently followed up for a minimum of 1 year between November 2009 and March 2018. The clinical outcomes were evaluated by comparing the range of motion (ROM), grip strength, the modified Mayo Wrist Score, and visual analog scale (VAS) scores for pain, all of which were measured preoperatively and at the last follow-up. The radiologic outcomes were evaluated by comparing the scapholunate (SL) and radiolunate (RL) angles preoperatively and at the last follow-up. All 15 cases of nonunion were resolved. The average radiologic union time was 9.7 ± 1.2 weeks. The average VAS score increased from 5.7 ± 2.3 (range, 2 − 10) preoperatively to 1.3 ± 1.3 (range, 0 − 3) at the last follow-up ( P < .05). The average modified Mayo wrist score increased from 58.3 ± 14.0 preoperatively to 80.0 ± 9.2 at the last follow-up ( P < .05). The mean ROM of the wrist improved, but there was no statistical significance. At the last follow-up, the mean flexion and radial deviation on the affected side were significantly decreased, and the mean extension on the affected side was significantly improved compared to the normal side ( P < .05). The mean preoperative SL and RL angles were 66 ± 11.9° and 7.2 ± 6.8°, respectively, and were decreased to 50.4 ± 7.5° and 6.4 ± 5.2°, respectively, at the last follow-up. The mean SL angle was significantly corrected ( P = .01). Arthroscopic bone grafting and percutaneous Kerschner (K)-wire fixation without radial styloidectomy are considered to be very effective methods for correcting scaphoid deformities to treat SNAC stage I. However, caution may be needed during the surgery to prevent reductions in flexion and the radial deviation of the wrist.

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“…The motion of the wrist also alters and a reduction in grip strength is also seen. Moreover, some patients also develop carpal arthritis [3]. There are multiple treatment techniques for the nondisplaced scaphoid fracture that range from an external cast to open surgical management and percutaneous fixation.…”

Section: Introductionmentioning

confidence: 99%

Functional Outcomes of Fixation of the Scaphoid Fracture with Herbert Screw: A Cross-Sectional Study

Keerio¹,

Chandio²,

Bhatti³

et al. 2023

PJMHS

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Objective: The present study aims at the assessment of the radiological union and clinical outcomes of scaphoid fracture followed by fixation by Herbert Screw. Study design: A cross-sectional study Place and Duration: This study was conducted Muhammad Medical College and Hospital Mirpurkhas from may 2021 to may 2022 Methodology: A total of 20 patients were included in the study and all of them had sustained a scaphoid fracture. All of them were treated with Herbert screw fixation. Overall 18 of them were male and 2 were female. Serial radiographs were obtained for the assessment of union and the Modified Mayo wrist scoring (MMWS) system was used for the assessment of functional outcomes. The patients were called after 6 months of surgery for a follow-up visit. A total of 9 (45%) patients were treated within the first week of the injury. Overall 5 (25%) were treated in two weeks and 6 (30%) were treated in 2 to 4 weeks Results: Out of 20 patients included in the study, 17 had fractured at the waist of the scaphoid and the remaining 3 had sustained fractures at the proximal pole of the scaphoid. The dorsal and volar approach of fixation by Herbert Screw was used for treating all the fractures. A good alignment was observed post-operatively. Out of all the 20 patients, 12 (60%) patients showed excellent outcomes with a full range motion of the wrist, 6 (30%) had shown good results, and 2 (10%) showed poor results. A final follow-up was arranged during the sixth month of treatment and 18 (90%) patients showed adequate radiological union. Conclusion: Fixation of scaphoid fracture with a Herbert Screw in a convenient and effective mode of treatment which has shown excellent functional outcomes and exceptionally reduced complications. Keywords: Herbert Screw, Fixation, Functional outcomes, Scaphoid fracture

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Management of scaphoid nonunion with avascular necrosis using 1,2 intercompartmental supraretinacular arterial bone graft

Cited by 9 publications

References 10 publications

Clinical and functional outcomes of vascularized bone graft in the treatment of scaphoid non-union

Clinical and functional outcomes of vascularized bone graft in the treatment of scaphoid non-union

Arthroscopy-assisted bone grafting for the treatment of SNAC stage I without radial styloidectomy

Functional Outcomes of Fixation of the Scaphoid Fracture with Herbert Screw: A Cross-Sectional Study

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