Nonunion of the scaphoid treated by anterior vascularized bone graft： a review of 26 cases

作     者：Mohamed Faouzi Hamdi Karim Amara Lamjed Tarhouni Sayed Baccari 

作者机构：Department of Trauma and Orthopaedic Surgery F.Bourguiba University Hospital Monastir 5000 Tunisia Department of Hand and Reconstructive Surgery Institute Kassab of Trauma and Orthopaedic SurgeyManouba 2010 Tunisia 

出 版 物：《Chinese Journal of Traumatology》 (中华创伤杂志（英文版）)

年 卷 期：2011年第14卷第4期

页      面：205-208页

学科分类：0403[教育学-体育学] 1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：Scaphoid bone Pseudarthrosis Bone transplantation Radius 

摘      要：[Abstract] Objective： To evaluate the clinical and radiological outcome of anterior vascularized bone graft in the treatment of primitive nonunion of the scaphoid. Methods： This is a retrospective study of 26 scaphoid nonunion cases treated by this technique between 2004 and 2009. The mean age was 38 years. Nonunion was of types IIA and IIB according to the Alnot＇s classification and only one case showed a proximal pole necrosis （type IV）. The fixation was ensured by K-wire. The mean immobilization period was 9 weeks. Results： At mean 19 months follow-up, the bone union rate was 88.5%. Failure was noted in three cases. No significant complications secondary to this technique were observed. The mobility in extension and flexion had an average recovery of 18°. Nineteen patients （73%） were free of pain, and the others had occasional pain Conclusions： It is a meticulous surgical technique that provides better union rates than those of conventional scaphoid graft. This technique is first adopted in cases of failure of conventional grafts in the treatment of scaphoid nonunion but the encouraging results suggest expanding indications to primitive nonunion.