Thumb metacarpal vascularized bone graft in long-standing scaphoid nonunion—a useful graft via dorsal or palmar approach: A cohort study of 24 patients

Bertelli, Jayme Augusto; Tacca, Cristiano Paulo; Rost, Jan Richard

doi:10.1016/j.jhsa.2004.06.007

Cited by 56 publications

(49 citation statements)

References 24 publications

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“…Lateral thenar artery coursed under the tendon of the extensor pollicis brevis muscle and ran subcutaneously along the lateral border of the abductor (1) and the thumb (2). Note the radial artery (3) and its branches: the superficial palmar branch (4), the lateral thenar artery (5), and their anastomotic vessels (arrows), the middle thenar artery (6), the second dorsal metacarpal artery (7), the lateral palmar digital artery of the thumb (8), the medial palmar digital artery of the thumb (9); 10 -index finger; 11 -ulnar artery (ventral view).…”

Section: Resultsmentioning

confidence: 99%

“…The same area has been studied previously by two authors [1,12]. Bertelli et al [1,2] studied 'the first dorsal metacarpal artery' with clinical application as a donor site for a vascularised bone graft in scaphoid bone non-union. Moschella and Cordova [12] reported 'the dorsal radial digital collateral artery' following the radial side of the thumb, and they proposed the reverse pedicled skin flap on this artery as a useful option for repairing the thumb.…”

Section: Discussionmentioning

confidence: 99%

“…Only a few articles have been devoted to the cutaneous blood supply of the thenar eminence itself [4,13,16], and there are only scarce data available on the clinical importance of the collateral branches of the radial artery (RA) within the A. Zekavica et al, Arteries of the thenar eminence anatomical snuff-box [7,9,18]. To our knowledge, there are only 3 articles in the literature which partly address the microanatomy of the RA branches in this region [1,2,14].…”

Section: Introductionmentioning

confidence: 99%

“…The conversance of thenar eminence vascularisation is the basis for the design and harvesting the flaps for reconstruction in numerous cases: palmar skin defects, loss of fingertip pulp with tendon and bone, in nerve exposure, or in case of a longstanding scaphoid bone non-union [2,5,17]. Therefore, insufficiency of relevant anatomic data and great surgical significance of this small area call for a study with scientific and practical implications.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Vascular anatomy of the thenar eminence: its relevance to a pedicled or free thenar flap

Zekavica

Milisavljevic²,

Erić³

et al. 2017

Folia Morphol

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show abstract

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Vascular anatomy of the thenar eminence: its relevance to a pedicled or free thenar flap

Zekavica

Milisavljevic²,

Erić³

et al. 2017

Folia Morphol

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“…After one year, bone union was reported in 21 (87%) patients and fibrotic union in 3 (13%) patients. The shape of the scaphoid shape was corrected, which ultimately increased the wrist range of motion and grip strength (28).…”

Section: Discussionmentioning

confidence: 99%

Results of Scaphoid Nonunion Treatment with Vascularised Bone Grafting from the Distal Radius

Żyluk¹,

Walaszek²

2008

Polish Journal of Surgery

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Misdiagnosis or failed treatment of scaphoid fractures are frequently (25-45%) followed by disrupted healing and nonunion. This may reduce the wrist's capacity for occupational and daily use and, over time, lead to wrist arthrosis. Therefore, surgery is recommended even in asymptomatic nonunions of the scaphoid; the goal of this treatment is to achieve bone union and stability of the wrist. The aim of the study was to evaluate the results of operative management of scaphoid nonunion by vascularized bone grafting from the distal radius. Material and methods. Eleven patients, nine men and two women of a mean age of 29 (range 19-45 years) with scaphoid nonunion lasting a mean of 10 months (range 8-20) were recruited. The nonunion was localized in the waist of the scaphoid in seven patients and in proximal 1/3 in four patients. Operations were performed using cancellous bone grafts taken from the distal radius and supplied by the intercompartmental branch of the radial artery. Fracture fixation was accomplished with K-wires or headless canullated screws. The follow-up assessment at a mean of 10 months included measurements of wrist range of motion, grip strength and Mayo wrist score. Results. All patients achieved bone union. The mean Mayo wrist score increased from 25 points preoperatively to 75 points at the final assessment, which suggested significant improvement of the hand functions. In a qualitative evaluation, two patients had an excellent result, four had a good result, four had a fair result and one had a poor result. Surgery resulted in significant pain relief and increase in hand strength, but failed to improve wrist range of motion. The modest clinical outcomes do not allow a definitive conclusion to be reached, but the fact that bone union was achieved in all patients with no complications justifies continued use of this technique for the management of scaphoid nonunion.

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Nonunions of the Scaphoid

Suh

Grewal

2011

Evidence‐Based Orthopedics

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Thumb metacarpal vascularized bone graft in long-standing scaphoid nonunion—a useful graft via dorsal or palmar approach: A cohort study of 24 patients

Cited by 56 publications

References 24 publications

Vascular anatomy of the thenar eminence: its relevance to a pedicled or free thenar flap

Vascular anatomy of the thenar eminence: its relevance to a pedicled or free thenar flap

Results of Scaphoid Nonunion Treatment with Vascularised Bone Grafting from the Distal Radius

Nonunions of the Scaphoid

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