A Comparison of the Use of Distal Radius Vascularised Bone Graft and                     Non-Vascularised Iliac Crest Bone Graft in the Treatment of Non-Union of                     Scaphoid Fractures

Silva, Jefferson Braga; Peruchi, Fabian Maccarini; Moschen, G. M.; Gehlen, Daniel; Padoin, Alexandre Vontobel

doi:10.1177/1753193408090400

Cited by 61 publications

(48 citation statements)

References 34 publications

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“…This includes bony union and restoring scaphoid alignment for functional improvement. It is known that re-establishment of the scaphoid length can relieves pain, improves grip strength and prevents degenerative changes 17 . To achieve these goals, a number of surgical approaches are available, including bone grafting, internal fixation, or a combination of both 11 .…”

Section: Discussionmentioning

confidence: 99%

“…Assessments were made on posteroanterior (PA) views of neutral and deviation position and lateral views with the forearm in neutral rotation. Severity of collapse was measured based on intrascaphoid (IS) angle 16 and scapholunate (SL) angle 17 on CT. Fracture union was defined according to the criteria described by Dias 18 and assessed at final follow-up from radiographs or with CT scans if the radiological appearances were inconclusive.…”

Section: Methodsmentioning

confidence: 99%

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Results of Iliac Bone Graft with Kirschner Wire Fixation for Scaphoid Nonunions

Kim¹,

Lim

Kim

2017

J Korean Soc Surg Hand

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This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/bync/ 3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Purpose:To determine clinical and radiographic results of iliac bone grafting with Kirschner wire fixation for treatment of scaphoid nonunions. Methods: A total of 13 patients who had scaphoid nonunion treated with iliac bone grafting and Kirschner wire fixation between October 2007 and January 2016 were enrolled as subjects of this study. Their clinical results were evaluated, including range of motion of the wrist joint and modified Mayo wrist score. Radiographic results including lateral intrascaphoid angle and scapholunate angle were also assessed. Results: Bony union was achieved in 11 (84.6%) of 13 cases. Modified Mayo wrist score was improved from 64.0 preoperatively to 87.5 postoperatively. Average intrascaphoid angle was improved from 39.5° preoperatively to 27.2° postoperatively while scapholunate angle was improved from 66.0° preoperatively to 55.1° postoperatively. Conclusion: Iliac bone graft with Kirschner wire fixation provided good clinical and radiographic results. Therefore, iliac bone graft with Kirschner wire fixation can be considered as a good treatment option for scaphoid nonunion.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Results of Iliac Bone Graft with Kirschner Wire Fixation for Scaphoid Nonunions

Kim¹,

Lim

Kim

2017

J Korean Soc Surg Hand

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“…To date, literature focusing on a direct comparison of vascularized versus non-vascularized cortico-spongious bone grafts for the treatment of SN is limited. 23 Here, we present a retrospective analysis of SN patients treated with vascularized or with non-vascularized cortico-spongious bone graft in a single center over a 13-year period. Functional and radiologic outcomes as well as quality of life (QoL) were analyzed to gain more evidence for individualized indications and surgical strategy.…”

Section: Introductionmentioning

confidence: 99%

Vascularized versus non-vascularized bone grafts in the treatment of scaphoid non-union

Hirche

Xiong

Heffinger

et al. 2017

J Orthop Surg (Hong Kong)

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Introduction: Conventional non-vascularized bone grafts as well as vascularized bone grafts are used to treat scaphoid non-union (SN). Due to limited available studies, the field of application using both grafts for SN still remains controversial. The aim of this study was to evaluate a treatment algorithm for the use of both vascularized versus non-vascularized bone grafts based on clinical outcomes and quality of life (QoL) to improve the level of evidence. Materials and Methods: Based on a retrospective cohort study, including 28 patients with vascularized and 45 patients with conventional bone grafts, functional parameters, radiological outcome, Mayo-wrist-score, and QoL by SF-36 were applied to statistically compare the outcome of these two techniques. Results: Time between last procedure or trauma and study group scaphoid reconstruction was almost double in the vascularized bone grafting group. Comparable union rates were achieved with vascularized as well as non-vascularized bone grafts. Significant differences were observed between both groups for grip strength and radial-ulnar active range of motion. Further functional outcomes, radiological outcomes as well as QoL were found similar for both techniques in patients with surgical union. Discussion and conclusions: In order to achieve comparable and appropriate treatment results, vascularized bone grafts are recommended for patients with delayed treatment, impaired scaphoid vascularity, and revision surgery. Even in preselected, complex cases, the results are comparable to conventional grafts, which are the basis for further patient education and approve the powerful role of surgical angiogenesis of vascularized bone grafts.

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“…Four studies of fibular and iliac crest grafts to the mandible [20,35,41,50] and two studies of grafts from the iliac crest and radius to the scaphoid [7,37] that directly compared VBGs and NVBGs were identified and excluded from the search. These studies are inconclusive with respect to whether VBGs outperform NVBGs at increasing length, and are no basis to make clinical recommendations regarding long-bone and large-joint defects.…”

Section: Discussionmentioning

confidence: 99%

Vascularized versus Nonvascularized Bone Grafts: What Is the Evidence?

Allsopp

Hunter-Smith

Rozen

2016

Clinical Orthopaedics &Amp; Related Research

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Background There is a general perception in practice that a vascular supply should be used when large pieces of bone graft are used, particularly those greater than 6 cm in length for long-bone and large-joint reconstructions. However, the scientific source of this recommendation is not clear. Questions/purposes We wished to perform a systematic review to (1) investigate the origin of evidence for this 6-cm rule, and (2) to identify whether there is strong evidence to support the importance of vascularization for longer grafts and/or the lack of vascularization for shorter grafts. Methods Two systematic reviews were performed using SCOPUS and Medline, one for each research question. For

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A Comparison of the Use of Distal Radius Vascularised Bone Graft and Non-Vascularised Iliac Crest Bone Graft in the Treatment of Non-Union of Scaphoid Fractures

Cited by 61 publications

References 34 publications

Results of Iliac Bone Graft with Kirschner Wire Fixation for Scaphoid Nonunions

Results of Iliac Bone Graft with Kirschner Wire Fixation for Scaphoid Nonunions

Vascularized versus non-vascularized bone grafts in the treatment of scaphoid non-union

Vascularized versus Nonvascularized Bone Grafts: What Is the Evidence?

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