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A vascularized bone graft from the dorsoradial aspect of the distal radius was used with internal fixation to treat nonunion of the scaphoid in ten patients who had not received any previous surgical treatment. Five cases were classified as Lichtman type I and five as type II. The average age was 30 years (range, 18-40 years). Associated avascular necrosis was observed in five cases. Postoperatively pain was relieved and union was achieved in all cases. The mean time to union was 6.5 weeks. Range of motion, grip strength and pinch strength were also restored satisfactorily. These results suggest that this vascularized bone graft should be used as the primary procedure in Lichtman type I and II of scaphoid nonunions, regardless of the presence of avascular necrosis of the proximal pole.

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purpose. To compare computed tomography (CT)-guided core needle biopsy (CNB) with incisional biopsy in diagnosing musculoskeletal lesions. Methods. 62 men and 50 women aged 12 to 83 (mean, 45) years who underwent a CT-guided CNB were compared with 31 men and 33 women aged 9 to 81 (mean, 53) years who underwent an incisional biopsy. All specimens had final pathology report to compare with. Comparisons were made in terms of (1) diagnostic rate, (2) accuracy in distinguishing benign from malignant lesions, (3) accuracy in distinguishing low-from high-grade sarcomas, (4) accuracy for histological diagnosis, and (5) p=1.00), the accuracy for specific diagnosis (75.9% vs. 85.2%, p=0.17), the repeated biopsy rate (6.3% vs. 4.7%, p=0.75), and the complication rate (0.9% vs. 4.7%, p=0.14). The accuracy for specific diagnosis was higher for bone than soft-tissue lesions for both CTguided CNB (87.0% vs. 59.5%, p=0.002) and incisional biopsy (87.0% vs. 77.3%, p=0.43). The accuracy of CT-guided CNB for specific diagnosis of benign softtissue tumours as well as infection and inflammation was relatively low. conclusion. CT-guided CNB is safe, easy to perform, efficient, and less invasive, and should be considered as a first-line biopsy for musculoskeletal lesions.