A capsular-based vascularized distal radius graft for proximal pole scaphoid pseudarthrosis.
OBJECTIVE
To evaluate the clinical results of the application of a capsular-based dorsal distal radius vascularized bone graft in scaphoid proximal pole nonunions.


METHODS
Thirteen patients with symptomatic nonunion at the proximal pole of the scaphoid (10 with avascular necrosis) were treated and reviewed retrospectively. The vascularized bone graft was harvested from the distal aspect of the dorsal radius and was attached to a wide distally based strip of the dorsal wrist capsule. It was inserted press-fit into a dorsal trough across the nonunion site after scaphoid fixation with a Herbert screw.


RESULTS
After a mean follow-up period of 19 months 10 of the 13 nonunions (8 of the 10 with avascular necrosis) achieved solid bone union. No complications other than the 3 persistent nonunions occurred.


CONCLUSIONS
Results of the use of a capsular-based vascularized bone graft from the distal radius for proximal pole scaphoid nonunions compare favorably with the results of pedicled or free vascularized grafts. It is a simple technique that eliminates the need for dissection of small-caliber pedicle or microsurgical anastomoses. No donor site morbidity was observed.


METHODS
Therapeutic, Level IV.
Sotereanos
Dean G
DG
Department of Orthopaedic Surgery, Allegheny General Hospital, Pittsburgh, PA 15212, USA. dsoterea@hotmail.com
Darlis
Nickolaos A
NA
Dailiana
Zoe H
ZH
Sarris
Ioannis K
IK
Malizos
Konstantinos N
KN
D000328:Adult; D001863:Bone Screws; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal; D017102:Fracture Healing; D018737:Hand Strength; D006801:Humans; D008297:Male; D011542:Pseudarthrosis / Q000601:surgery*; D011884:Radius / Q000098:blood supply* / Q000637:transplantation*; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D021361:Scaphoid Bone / Q000293:injuries* / Q000601:surgery*