[Proximal scaphoid pseudarthrosis with avascular pol fragment: long-term outcome after reconstruction with microvascular pedicled iliac crest bone graft].
56 patients suffering from scaphoid nonunion with avascular necrosis of the proximal pole were treated by a free vascularized iliac bone graft. Follow-up examination of 27 patients at 8.8 years included evaluation of scaphoid nonunion, progression of arthrosis and clinical parameters. Union was achieved in 85% of the patients (Group A). Arthrosis remained unchanged in 75%. No carpal collapse occurred. 81% of the patients were painfree. Grip strength was 95% and range of motion 75% compared to the noninvolved wrist. Nonunion persisted in 15% (Group B). In all these patients carpal collapse had established. 66% of the patients showed mild pain. Grip strength was 71% and range of motion 65% of normal. Transplantation of a free vascularized iliac bone graft resulted in union of a scaphoid pseudarthrosis with avascular proximal pole in 85%. When union occurred, progression of degenerative arthrosis could be arrested and good clinical late results could be achieved.
Universitätsklinik für Unfallchirurgie, Innsbruck.
M
M
Gabl
C
C
Reinhart
S
S
Pechlaner
H
H
Hussl
D000293:Adolescent; D000328:Adult; D016025:Bone Transplantation; D002348:Carpal Bones / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000601:surgery; D010020:Osteonecrosis / Q000000981:diagnostic imaging / Q000601:surgery*; D011542:Pseudarthrosis / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D016896:Treatment Outcome; D014954:Wrist Injuries / Q000000981:diagnostic imaging / Q000601:surgery*
Proximale Kahnbeinpseudarthrose mit avaskulärem Polfragment: Langzeitergebnisse nach Rekonstruktion mit mikrovaskulär gestieltem Beckenkammspan.