Scaphoid Nonunion Treated With Vascular Bone Grafts Pedicled on the Dorsal Supra-retinacular Artery of the Distal Radius

Chen, Alvin Chao‐Yu; Chao, En-Kai; Tu, Yuan‐Kun; Ueng, Steve Wen–Neng

doi:10.1097/01.ta.0000234723.78487.52

Cited by 35 publications

(21 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Malizos et al [35] reviewed 30 wrists that underwent vascularised bone graft and all of the fractures healed by 12 weeks. Chen et al [36] reviewed the outcomes of using dorsal distal radius pedicled VBG in nonunions. All of the nonunions healed at an average 13 weeks.…”

Section: Discussionmentioning

confidence: 99%

Scaphoid nonunion treated with vascularised bone graft from dorsal radius

Özalp

Öz

Kale

et al. 2015

Injury

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Scaphoid nonunion treated with vascularised bone graft from dorsal radius

Özalp

Öz

Kale

et al. 2015

Injury

View full text Add to dashboard Cite

“…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

View full text Add to dashboard Cite

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.

show abstract

“…However up to 45% of these fractures [4,5], often those occurring in young active patients [6], progress to a nonunion. The most common causes of scaphoid nonunion (SNU) relate to inadequate fracture immobilization (in terms of duration and type of immobilization), patient non-compliance with treatment, misdiagnosis, fracture displacement and associated carpal instability [3,7,8].…”

Section: Introductionmentioning

confidence: 99%

“…the proximal pole), the development of scaphoid avascular necrosis (AVN), having had a previous styloidectomy (1), and the presence of a scaphoid humpback deformity [11]. SNU treatment options are:(i) fracture fixation alone, without bone grafting [12]; (ii) the use of non-vascularized bone grafting without internal fixation [13,14]; (iii) non-vascularized bone grafting with internal fixation [3,7,15-17]; (iv) the use of vascularized bone grafts, with or without internal fixation [18-20], with a recent systematic review reporting union rates of 80% using bone graft without fixation, 85% using bone graft with fixation, and 91%-100% using vascularized bone grafts [4,13,19]. …”

Section: Introductionmentioning

confidence: 99%

The treatment of scaphoid nonunion using the Ilizarov fixator without bone graft, a study of 18 cases

et al. 2011

View full text Add to dashboard Cite

ObjectivesEvaluating the safety and efficacy of the Ilizarov fine-wire compression/distraction technique in the treatment of scaphoid nonunion (SNU), without the use of bone graft.DesignA retrospective review of 18 consecutive patients in one centre.Patients and Methods18 patients; 17 males; 1 female, with a mean SNU duration of 13.9 months. Patients with carpal instability, humpback deformity, carpal collapse, avascular necrosis or marked degenerative change, were excluded. Following frame application the treatment consisted of three stages: the frame was distracted 1 mm per day until radiographs showed a 2-3 mm opening at the SNU site (mean 10 days); the SNU site was then compressed for 5 days, at a rate of 1 mm per day, with the wrist in 15 degrees of flexion and 15 degrees of radial deviation; the third stage involved immobilization with the Ilizarov fixator for 6 weeks. The technique is detailed herein.ResultsRadiographic (CT) and clinical bony union was achieved in all 18 patients after a mean of 89 days (70-130 days). Mean modified Mayo wrist scores improved from 21 to 86 at a mean follow-up of 37 months (24-72 months), with good/excellent results in 14 patients. All patients returned to their pre-injury occupations and levels of activity at a mean of 117 days. Three patients suffered superficial K-wire infections, which resolved with oral antibiotics.ConclusionsIn these selected patients this technique safely achieved bony union without the need to open the SNU site and without the use of bone graft.

show abstract

Scaphoid Nonunion Treated With Vascular Bone Grafts Pedicled on the Dorsal Supra-retinacular Artery of the Distal Radius

Abstract: The index study suggests that this treatment can be used not only to revascularize necrotic scaphoid, but also to correct humpback deformity and the resulting carpal instability.

Cited by 35 publications

References 26 publications

Scaphoid nonunion treated with vascularised bone graft from dorsal radius

Scaphoid nonunion treated with vascularised bone graft from dorsal radius

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

The treatment of scaphoid nonunion using the Ilizarov fixator without bone graft, a study of 18 cases

Contact Info

Product

Resources

About