The fragmented proximal pole scaphoid nonunion treated with rib autograft: case series and review of the literature.
Nonunions of the proximal pole of the scaphoid are a challenge to treat given the limited vascular supply. This challenge is potentiated when the proximal pole is unsalvageable. When the proximal pole of the scaphoid is fragmented or otherwise unsalvageable, traditional reconstructive procedures such as vascularized or nonvascularized bone grafting are not possible. Salvage procedures such as proximal row carpectomy or scaphoid excision and partial wrist fusion would not be ideal in the case of an unsalvageable proximal pole scaphoid nonunion in the absence of radiocarpal arthrosis. In this relatively uncommon circumstance, we favor the use of rib osteochondral autograft reconstruction of the proximal pole of the scaphoid. We report 3 cases with greater than 2-years of follow-up evaluation and also review the literature.
Robert A. Chase Hand and Upper Limb Center, Stanford University School of Medicine, Redwood City, CA. Electronic address: yao_jeffrey@yahoo.com.
Jeffrey
J
Yao
Blake
B
Read
Vincent R
VR
Hentz
D000328:Adult; D064592:Autografts; D005538:Football / Q000293:injuries*; D005599:Fractures, Ununited / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D012272:Ribs / Q000637:transplantation*; D021361:Scaphoid Bone / Q000000981:diagnostic imaging / Q000293:injuries*; D014057:Tomography, X-Ray Computed; D055815:Young Adult
Autograft; costochondral; nonunion; osteochondral; rib; scaphoid