Background The treatment for scaphoid nonunion with avascular necrosis is vascularized and non-vascularized bone grafts. A vascularized bone graft promotes biological healing and revascularizes ischemic bone. The purpose of this retrospective study is to analyze the outcome of 1,2 intercompartmental supraretinacular artery (1,2-ICSRA)-based vascularized graft in scaphoid nonunion with avascular necrosis. Materials and methods We treated 11 patients with scaphoid nonunion with avascular necrosis using a (1,2-ICSRA)-based vascular graft and Herbert screw fixation between 2013 and 2017. Plain radiographs, computed tomography (CT) scan, magnetic resonance imaging (MRI) confirmed the avascular necrosis in all patients. We noted the age, delay in treatment, time for bone union, preoperative range of movements, grip strength, scapholunate, intrascaphoid angle, and radiolunate angles. We confirmed the bone union by CT scan and measured the functional outcome with pain score, modified Mayo wrist score, grip strength, range of movement, and Disabilities of the Arm, Shoulder, and Hand (DASH) score. Results The mean age of the patients was 29 years (range 20-42 years). The mean follow-up was 31 months (range, 26-36 months). All patients achieved good radiological union and revascularization of the proximal pole necrosis at an average of 14 weeks (range, 12-18 weeks). There was a significant postoperative improvement in grip strength, visual analog scale VAS score, intrascaphoid angle, scapholunate angle, and radiolunate angle (p<.05). The mean range of wrist flexion was 88%, extension 70%, radial deviation 80%, and ulnar deviation 85% of the opposite side. Conclusions Scaphoid nonunion with avascular necrosis can be treated with a 1,2-ICSRA-based vascularized bone graft. Vascularized bone grafts promote biological healing and revascularization of the ischemic bone.
Unilateral congenital ulna deficiency of wrist and forearm is rare. It is associated with cartilaginous ulnar anlage, absence of ulnar digits, carpus, partially or completely absent ulna, radiohumeral synostosis, syndactyly, and thumb abnormalities. Various classifications have described this presentation. We report a new variant of type I congenital ulnar deficiency in wrist and forearm with a normal thumb, first webspace, hand, wrist, and elbow in an 18-year-old girl.
Isolated aspergillus infection of the lower limb is uncommon and needs more focus in terms of understanding the pathogenicity, ecological and geographical distribution, identification of species, management and follow-up. Aspergillus flavus involving the lower limb in an immunocompetent individual is a rare entity. Surgical management and antifungal therapy are the mainstays of treatment. We report a 44-year-old farmer who presented with right lower limb swelling of short duration, operated, diagnosed with isolated species of Aspergillus flavus, treated successfully with oral voriconazole to produce excellent wound healing and functional outcome at four years follow-up.
Soft tissue cover to the hand can be as simple as a skin graft, local, distant flaps to a complex microvascular free flap. Posterior interosseous artery (PIA) flap is a technically demanding robust flap which can be used to cover a wide range of hand and wrist defects. We report a 25year-old lady who had severe crush injury where the posterior interosseous flap was planned to cover the dorsum of hand defects. On exploration carefully, the PIA was found to be congenitally absent. An alternative groin flap salvaged the procedure and the patient had good aesthetic and functional outcomes at the five years of follow-up.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.