[Treatment of difficult scaphoid pseudarthroses by bone transplantation and additional implantation of the second dorsal metacarpal artery using the Fernandez and Eggli technique--report of experiences].
One of the procedures for the treatment of scaphoid-nonunion with loss of blood supply to the proximal fragment involves the technique described by Fernandez and Eggli (1995). After resection of the necrotic bone and inserting a corticocancellous bone graft from the iliac crest, the second dorsal intermetacarpal artery is implanted into the proximal fragment of the scaphoid. In our hospital, six patients underwent this procedure from May 1998 to June 2000 because of necrosis of the proximal pole or an unsuccessful previous operation. Union was achieved in five patients. In one case, nonunion persisted and the cystic area increased. The described technique is suitable for improvement of bone healing of the scaphoid in complicated cases. The advantages of this technique lie in the predictable anatomy of the second intermetacarpal artery and the straightforward dissection.
Bartelmann
U
U
Klinik für Handchirurgie, Abteilung II, Rhön-Klinikum Salzburger Leite 1 97616 Bad Neustadt/Saale. bartelmann@nexgo.de
Kalb
K
K
D000328:Adult; D001158:Arteries / Q000637:transplantation*; D016025:Bone Transplantation / Q000379:methods*; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal; D017102:Fracture Healing / Q000502:physiology; D005599:Fractures, Ununited / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008866:Microsurgery; D010020:Osteonecrosis / Q000000981:diagnostic imaging / Q000601:surgery; D011542:Pseudarthrosis / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D012086:Reoperation; D021361:Scaphoid Bone / Q000098:blood supply / Q000000981:diagnostic imaging / Q000293:injuries*
Behandlung schwieriger Skaphoidpseudarthrosen durch Knochentransplantation und zusätzliche Implantation der zweiten dorsalen Metakarpalarterie in der Technik nach Fernandez und Eggli--Erfahrungsbericht.