Results of treatment of scaphoid nonunion with microvascularized bone grafts of the 1,2 intercompartmental supraretinacular artery and osteosynthesis

Álvarez-Castro, Ana; Río, A. Ramos-del; Diez-Romero, J.; Alonso-Recio, A.; Fernández-Hernández, Ó.; Juárez-Cordero, C.; Sánchez-Lázaro, J.

doi:10.1016/j.recote.2014.01.003

Cited by 2 publications

(2 citation statements)

References 30 publications

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“…We excluded those in which the 1,2‐ICSRA (1,2‐intercompartmental, supraretinacular art.) flap is used and that consist of a separate group . Another group includes patients in whom a volar flap was based on the anterior transverse carpal artery, while a fourth one includes those wherein a pronator quadratus pedicled flap was used .…”

Section: Methodsmentioning

confidence: 99%

Comparative meta-analysis on the various vascularized bone flaps used for the treatment of scaphoid nonunion

et al. 2017

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We did a meta-analysis of the literature in order to clarify which of the vascularized bone flaps (VBF) used for scaphoid non-union treatment has the best outcome with regard to various parameters. We analyzed 54 articles that present nine different types of VBF. The analysis concerned demographical patient information, radiographic parameters, fracture classification, including the presence or non-presence of avascular necrosis of the scaphoid proximal pole (PP AVN), parameters that have to do with the surgery itself and the postoperative protocol, the healing of the nonunion and functional scores. The meta-analysis showed best healing potential for the femoral graft despite the complexity of the operation. On the other hand, the most commonly used 1,2-ICSRA flap makes the procedure more reproducible but showed worse results. The femoral flap was also among the most successful flaps when used for patients with PP AVN. The consolidation rate, in general, was not affected by the time elapsed between the fracture and the operation but by smoking and the presence of PP AVN. The meta-analysis could not reach many significant statistical conclusions because of either the small number of patients in some flap groups or the heterogeneity and lack of documentation in most of the articles. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1076-1085, 2017.

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Section: Methodsmentioning

confidence: 99%

Comparative meta-analysis on the various vascularized bone flaps used for the treatment of scaphoid nonunion

et al. 2017

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“…Several different vascularized bone grafts exist which can be used [1,13,23,25,27,38,41,44]. One of them is a free vascularized graft from the medial femoral condyle (MFC), which can be harvested as an osteoperiosteal or osteochondral graft.…”

Section: Introductionmentioning

confidence: 99%

Clinical and radiological results of the vascularized medial femoral condyle graft for scaphoid non-union

Keller

Kastenberger

Anoar

et al. 2020

Arch Orthop Trauma Surg

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Introduction This study evaluated the use of a free vascularized bone graft with and without cartilage from the medial femoral condyle (MFC) in patients with recalcitrant scaphoid non-union, with a special focus on union rates and the osteochondral graft for proximal pole destruction. Materials and methods Thirty-eight avascular scaphoid non-unions in 37 patients who were treated with a free osteoperiosteal or osteochondral MFC graft were retrospectively evaluated (mean follow-up 16 months). Bone union, the scapholunate and the radiolunate angles were evaluated on X-ray images. The range of motion, grip strength, VAS, DASH and PRWE scores were evaluated clinically. Results The overall union rate was 95%. Bone union was achieved in 27 out of 29 (93%) scaphoids treated with a free osteoperiosteal MFC grafts and in 9 out of 9 (100%) scaphoids treated with a free osteochondral MFC graft. The range of motion remained almost unchanged, while grip strength increased significantly (34 kg vs. 44 kg) and the VAS (22-5), DASH (59-19) and PRWE (62-30) score decreased significantly. The scapholunate (71°-65°) and radiolunate (28°-18°) angle decreased. No major donor site morbidity was observed. Postoperative complications were observed in eight cases (21%). Conclusions The vascularized medial femoral bone graft leads to a good functional outcome in the treatment of scaphoid non-unions. The graft provides adequate blood supply and structural stability to the scaphoid. A proximal pole destruction can be replaced using an osteochondral graft with promising short-term results preventing carpal osteoarthritis and collapse.

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Results of treatment of scaphoid nonunion with microvascularized bone grafts of the 1,2 intercompartmental supraretinacular artery and osteosynthesis

Cited by 2 publications

References 30 publications

Comparative meta-analysis on the various vascularized bone flaps used for the treatment of scaphoid nonunion

Comparative meta-analysis on the various vascularized bone flaps used for the treatment of scaphoid nonunion

Clinical and radiological results of the vascularized medial femoral condyle graft for scaphoid non-union

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