Non-vascularized bone graft with Herbert-type screw fixation for proximal pole scaphoid nonunion
| Autor: | Hiroyuki Matsuki, Akio Minami, Jun-ichi Ishikawa, Norimasa Iwasaki, Hiroyuki Kato, Shigeharu Uchiyama |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Male musculoskeletal diseases medicine.medical_specialty Adolescent Radiography Bone Screws Nonunion Screw fixation Ilium Fracture Fixation Internal Young Adult Vascularity Fracture fixation medicine Humans Orthopedics and Sports Medicine Kirschner wire Child Retrospective Studies Scaphoid Bone Bone Transplantation business.industry musculoskeletal system medicine.disease Surgery surgical procedures operative Vascularized bone Fractures Ununited Orthopedic surgery Radiology medicine.symptom business |
| Zdroj: | Journal of Orthopaedic Science. 16:749-755 |
| ISSN: | 0949-2658 |
| DOI: | 10.1007/s00776-011-0158-8 |
| Popis: | Since proximal pole fractures of the scaphoid are frequently overlooked, the poor vascularity in the proximal pole fragment often leads to nonunion. Vascularized bone grafts have been recently tested in cases with scaphoid proximal pole nonunion, but the indication for this treatment has not been well established. Alternatively, we have been treating such patients with a non-vascularized iliac bone graft and Herbert-type screw fixation with considerable success. The purpose of this investigation is to evaluate these cases retrospectively and clarify the surgical efficacy of our procedure.Between 1996 and 2009, 11 consecutive patients with proximal pole scaphoid nonunion were treated with a non-vascularized corticocancellous iliac bone graft and Herbert-type screw fixation. They were all male aged from 12 to 26 years. In two patients, avascular changes were recognized in the proximal pole in preoperative radiographs or MRI. Follow-up ranged from 12 to 76 months.Bone union was radiographically confirmed in all patients, who returned to their former activities without any complications. The period from operation to union ranged from 12 to 24 weeks. The mean Mayo modified wrist score was 76.4 points preoperatively and 91.4 points postoperatively, and was improved in all cases.A non-vascularized iliac bone graft with Herbert-type screw fixation obtained satisfactory clinical and radiographic results in cases with scaphoid proximal pole nonunion, regardless of the vascularity in the proximal fragment. |
| Databáze: | OpenAIRE |
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