Abstract
Scaphoid nonunion without treatment can progress to carpal collapse and a predictable pattern of radiocarpal arthrosis. Surgical intervention is indicated to prevent progressive carpal instability and arthritis. In proximal pole nonunion and occasionally in scaphoid waist fracture with osteonecrosis, or when traditional bone grafting has failed to achieve union, vascularized bone grafts are used because they improve the biology of bone healing. This review describes the most common vascularized bone grafts used to treat scaphoid nonunion, either pedicled or free.
Highlights
Scaphoid fractures are the most common carpal fracture and continue to present diagnostic and therapeutic challenges
Inadequate initial management, proximal fracture location, osteonecrosis (ON), and associated carpal instability with acute scaphoid fracture can lead to nonunion of the scaphoid waist or the proximal pole [1]
The use of vascularized bone grafts (VBG) is more technically challenging than that of non-vascularized bone graft (NVBG), VBG improves the biology of healing, maximizes the odds of achieving union, and may help revascularize a necrotic proximal pole [4]
Summary
Carlos Ottolenghi “Italian Hospital of Buenos Aires, Argentina. Scaphoid nonunion without treatment can progress to carpal collapse and a predictable pattern of radiocarpal arthrosis. Surgical intervention is indicated to prevent progressive carpal instability and arthritis. In proximal pole nonunion and occasionally in scaphoid waist fracture with osteonecrosis, or when traditional bone grafting has failed to achieve union, vascularized bone grafts are used because they improve the biology of bone healing. This review describes the most common vascularized bone grafts used to treat scaphoid nonunion, either pedicled or free
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