The efficacy of 1,2- intercompartmental supraretinacular artery pedicled vascularised bone graft for scaphoid proximal end non-union and avascular necrosis


Published online: Dec 27 2017

Yüksel Özkan , Yavuz Akalın , Nazan Çevik , Gökhan Cansabuncu , Alpaslan Öztürk

From the Bursa High Research and Training Hospital, Department of Orthopedics and Traumatology Yildirim,

Abstract

The aim is to show the efficacy of 1,2-intercompartmental supraretinacular artery pedicled vascularised bone graft in treatment of scaphoid non-union with concomitant proximal end avascular necrosis retrospectively. Twentytwo cases of scaphoid nonunion with concomitant proximal end avascular necrosis were evaluated. Radiographic evaluation was made with radiographs, computed tomography, and magnetic resonance imaging. Clinical evaluation was made according to the Disabilities of the Arm, Shoulder and Hand (DASH) score, the Mayo wrist score, and the Short Form-36. Union was achieved in 18 81.8%. The mean age was 31.13 ± 5.29 years and the mean follow-up was 34.95±16.87 months. The median wrist flexionextension range was 123.5° (100°-144°) preoperatively and 128° (82°-146°) postoperatively. The median radial-ulnar deviation was measured as 41.5° (24°- 55°) preoperatively and 42° (24°-58°) postoperatively. The dominant hand was measured as 92% (p = 0.061) grip strength compared to the healthy side and the non-dominant side as 74% (p = 0.012). Improvement was observed in all patients in SF-36,DASH,Mayo score and in patients with union (p < 0.001). The radiological and clinical results of this study showed that 1,2- intercompartmental supraretinacular artery pedicled vascularised bone graft is an effective method in the treatment of scaphoid nonunion with concomitant proximal end avascular necrosis.