title: Treatment of scaphoid non-unions by a palmar approach with vascularised bone graft harvested from the thumb.
abstract: Ten patients with scaphoid non-unions which had been present for longer than 2 years were treated using a vascularised bone graft harvested from the thumb and pedicled on the first dorsal metacarpal artery. Bone harvesting and grafting were performed by a single palmar approach. Concomitant cancellous bone graft was not used. Bone healing was confirmed by CT scans in nine of the ten patients. Persistence of the non-union was observed in one patient who was the oldest in this series, had the longest standing non-union and was a heavy smoker. Twelve months after surgery, nine of the ten patients had significant pain relief with an improved range of motion and grip strength.
authors.affiliation: Hospital Governador Celso Ramos, Department of Orthopedics, Hand Surgery Unit, Florianópolis, SC, Brazil. bertelli@matrix.com.br
authors.forename: J A
authors.initials: JA
authors.lastname: Bertelli
authors.forename: F M
authors.initials: FM
authors.lastname: Peruchi
authors.forename: J R
authors.initials: JR
authors.lastname: Rost
authors.forename: C P
authors.initials: CP
authors.lastname: Tacca
mesh_terms: D000328:Adult; D016025:Bone Transplantation / Q000379:methods; D015331:Cohort Studies; D017102:Fracture Healing; D005599:Fractures, Ununited / Q000000981:diagnostic imaging / Q000601:surgery*; D018737:Hand Strength; D006801:Humans; D008297:Male; D050279:Metacarpal Bones / Q000098:blood supply* / Q000637:transplantation*; D008875:Middle Aged; D010147:Pain Measurement; D011859:Radiography; D016059:Range of Motion, Articular; D021361:Scaphoid Bone / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D013933:Thumb / Q000098:blood supply / Q000601:surgery*