Treatment of proximal scaphoid waist nonunions with vascularized bone graft from the distal radius or medial femoral condyle.

Autor: Polat O; Department of Orthopedic and Traumatology, Ağrı Training and Research Hospital, Ağrı, Turkey., Toy S; Department of Orthopedic and Traumatology, Ağrı Training and Research Hospital, Ağrı, Turkey., Kibar B; Department of Orthopedic and Hand Surgeon, Haydarpasa Numune Education and Research Hospital, İstanbul, Turkey.
Jazyk: angličtina
Zdroj: The Journal of hand surgery, European volume [J Hand Surg Eur Vol] 2022 Jun; Vol. 47 (6), pp. 610-617. Date of Electronic Publication: 2022 Jan 21.
DOI: 10.1177/17531934211073858
Abstrakt: Fractures of the proximal scaphoid waist are more prone to nonunion than distal scaphoid fractures. Thirty-nine patients (five females, 34 males; mean age 31 years) who had operation for proximal scaphoid waist nonunion between 2017 and 2020 were retrospectively analysed. Patients received a free vascularized medial femoral condyle graft (Group 1: 18 patients) or distal radial bone graft based on a 1,2 intercompartmental supraretinacular artery pedicle (Group 2: 21 patients). In Group 1, union was achieved in 17 of 18 cases, with mean time to union of 13 weeks and mean operation time was 221 minutes. In Group 2, union was achieved in 19 of 21 cases, with mean time to union of 15 weeks and mean operation time was 100 minutes. The radiological and functional results of both groups were similar. We recommend a distal radial bone graft based on the 1,2 intercompartmental supraretinacular artery pedicle for proximal scaphoid waist nonunions since the operation is shorter, technically more manageable and requires less microsurgical experience. Level of evidence: III.
Databáze: MEDLINE