Excellent Results After Bone Grafting and K-Wire Fixation for Scaphoid Nonunion Surgery in Skeletally Immature Patients

Abstract

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Vascularized thumb metacarpal periosteal pedicled flap for scaphoid nonunion: An anatomical study and pediatric case report

“…We disregarded nonbiological surgical techniques (Reigstad et al, 2013) and opted for a vascularized procedure, owing to our patient's grave clinical scenario (nonunion D4 12 ), which was characterized by both avascular necrosis of the proximal pole and nonunion that had persisted beyond four years, both significant predictors of a poor functional outcome (Bae, Gholson, Zurakowski, & Waters, 2016;Moon, Dy, Derman, Vance, & Carlson, 2013. This condition required both angiogenic and vascular resources (Bae et al, 2016;Moon et al, 2013;Sunagawa, Bishop, & Muramatsu, 2000).…”

“…Though most pediatric scaphoid fractures have a good prognosis with conservative management (Weber, Fricker, & Ramseier, ), scaphoid nonunion has been reported (Ahmed, Ashton, Tay, & Porter, ; Behr et al, ; Elhassan & Shin, ; Reigstad, Thorkildsen, Grimsgaard, Reigstad, & Rokkum, ). Since this lesion is a rarity, however—with a nonunion rate of just 0.8% (Elhassan & Shin, )—management experience is limited and optimal treatment remains controversial (Elhassan & Shin, ).…”

“…Since this lesion is a rarity, however—with a nonunion rate of just 0.8% (Elhassan & Shin, )—management experience is limited and optimal treatment remains controversial (Elhassan & Shin, ). Available treatment options include cast immobilization, bone grafting with K‐wire fixation, bone grafting without osteosynthesis, headless compression screw fixation with or without bone grafting, and vascularized bone grafting (Ahmed et al, ; Behr et al, ; Chloros et al, ; Elhassan & Shin, ; Hamdi & Khelifi, ; Reigstad et al, ; Weber et al, ).…”

“…We also state that the content of this article has been reviewed and approved by all the authors, in full belief that it has been written honestly and without plagiarism. 2014; Behr et al, 2014;Elhassan & Shin, 2006;Reigstad, Thorkildsen, Grimsgaard, Reigstad, & Rokkum, 2013). Since this lesion is a rarity, however-with a nonunion rate of just 0.8% (Elhassan & Shin, 2006)management experience is limited and optimal treatment remains controversial (Elhassan & Shin, 2006).…”

Pediatric Scaphoid Nonunions: A Case Series, Review of the Literature, and Evidence-Based Guidelines

“…36 Studies revealed an incidence of 0.4 per 100,000 females and 2 per 100,000 males. [41][42][43] An 8-year observation of discharge data revealed an incidence of 3 per 100,000 females and 39 per 100,000 males. 42,43 Pediatric scaphoid fractures usually occur at 11 to 15 years of age, 1,2,7,13,14,17,23 but fractures have been reported as early as 4 years, though not identified until years later.…”