title: Management of scaphoid nonunion with avascular necrosis using 1,2 intercompartmental supraretinacular arterial bone graft.
abstract: BACKGROUND
  1,2 ICSRA, introduced by Aidembery et al., is a well-established technique, with up to 100% union rate among different studies. The purpose of our study was to evaluate the outcome of scaphoid nonunion undergoing 1,2 ICSRA bone graft in Iran.
  
  
  METHODS
  All participants who presented sequentially over a period of 24 months between 2010 and 2013 with nonunion scaphoid fracture with AVN in proximal pole were included in the study. Anteroposterior and lateral view plain radiographs of carpal bones were obtained for diagnosis of nonunion, and a diagnosis of avascular necrosis was made by MRI of the scaphoid. Subjects underwent 1,2 ICSRA bone graft surgery. Patients were assessed based on radiographs and the Mayo Wrist Score (MWS) questionnaire on before and after surgery. Data were analyzed using SPSS ver. 18 by paired t test.
  
  
  RESULTS
  Overall, 16 patients (100% male) were included in the study. Mean age of subjects was 27.50 ± 5.86 (18 to 38). Mean Mayo score was 36.63 ± 8.92 and 83.75 ± 9.22 before and 6 month after surgery, respectively, and the difference was statistically significant (P < 0.001). after 8 weeks, 10 (62.5%) had union, and after 12 weeks, all subjects had union. Nine (56.25%) of our patients had excellent functional outcome, 5 (31.25%) had good and 2 (12.5%) had satisfactory functional outcome.
  
  
  CONCLUSIONS
  1,2 ICSRA is a proper pedicle of vascularized bone graft due to the ease of visibility and dissection. The functional results and union rates were satisfactory in our study.
authors.affiliation: Department of Orthopedic, Orthopedic Surgery, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Mohamad
authors.initials: M
authors.lastname: Dehghani
authors.affiliation: Department of Orthopedic, Orthopedic Surgery, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Mohamad
authors.initials: M
authors.lastname: Soltanmohamadi
authors.affiliation: Department of Orthopedic, Orthopedic Surgery, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Mohammad Ali
authors.initials: MA
authors.lastname: Tahririan
authors.affiliation: Department of Orthopedic, Orthopedic Surgery, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Moezi
authors.affiliation: Isfahan Medical Student Research Centre, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Parnaz
authors.initials: P
authors.lastname: Daneshpajouhnejad
authors.affiliation: Department of Orthopedic, Orthopedic Surgery, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Abolghasem
authors.initials: A
authors.lastname: Zarezadeh
keywords: 1, 2 ICSRA; Avascular necrosis; non-union; scaphoid