Vascularized Bone Graft from the Iliac Crest for the Treatment of Nonunion of the Proximal Part of the Scaphoid with an Avascular Fragment*

Gabl, M.; Reinhart, Claudia; Lutz, M.; Bodner, Gerd; Rudisch, A.; Hussl, H.; Pechlaner, S.

doi:10.2106/00004623-199910000-00006

Cited by 122 publications

(93 citation statements)

References 42 publications

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“…Still, the methods using vascularized bone grafts yielded union in 91% of cases and the problem of scaphoid nonunion seems to have been solved (Table 3). Yet some of the articles in the group involving vascularized bone grafting reported union rates of 60-80% (Braun 1983, Boyer et al 1998, Gabl et al 1999a, and in the last paper from 2002, Straw et al found a union rate of 27 (CI: 11-50)% in 22 patients-indicating that improvement in the treatment for scaphoid nonunion is still necessary (Table 3). Immobilization was reduced from 15 to 7 weeks due to internal fixation, and as Merrell et al (2002) have recently reported: "Immediate mobilization versus 6 weeks or more of casting showed the same union rate" in a meta-analysis of 12 studies with 519 patients having compression screw fixation and grafting.…”

Section: Discussionmentioning

confidence: 99%

Bone grafting the scaphoid nonunionA systematic review of 147 publications including 5 246 cases of scaphoid nonunion

Munk¹,

Larsen²

2004

Acta Orthopaedica Scandinavica

148

106

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Section: Discussionmentioning

confidence: 99%

Bone grafting the scaphoid nonunionA systematic review of 147 publications including 5 246 cases of scaphoid nonunion

Munk¹,

Larsen²

2004

Acta Orthopaedica Scandinavica

148

106

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“…Various surgical methods have been presented for scaphoid nonunion. However, the ideal treatment for scaphoid nonunion remains uncertain [5][6][7] . Usually, bone graft and internal fixation are conventional treatment for scaphoid nonunion.…”

Section: Introductionmentioning

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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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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“…Generally, the ÿnal selection relies on the surgical operation. Ilium, ÿbula and scapula are the most commonly used bone aps in microsurgery to repair bone deÿcit [6][7][8]. Due to the limited number of the clinical cases and the complex cadaveric measurement [18], there is no standard to judge which method is better for repairing the metatarsal deÿcit.…”

Section: Comparison Of Post-reparation Mechanical E Ects Among Three mentioning

confidence: 99%

“…There is little research in the in uence of forefoot deÿcit on foot function [4,5]. The vascularized autogenous bone ap is a preferable treatment for the reconstruction of the trauma-induced bone deÿcit [6][7][8]. Taylor [9] and Taylor et al [10] ÿrst utilized the freely vascularized bone grafts to repair foot deÿcit.…”

Section: Introductionmentioning

confidence: 99%

Finite element analysis of metatarsal deficit and reconstruction using ilium, fibula and scapula

Pan

Jiang

Wang

et al. 2006

Commun. Numer. Meth. Engng.

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SUMMARYObjective: To compare the mechanical e ects of metatarsal deÿcit and its reconstruction with ilium, ÿbula and scapula on foot function using three-dimensional (3-D) ÿnite element analysis.Methods: Deÿcits of the ÿrst to the third metatarsal bone and the fourth to the ÿfth metatarsal bone, and their reconstructions with ilium, ÿbula and scapula, respectively, were simulated by a 3-D foot model. The peak displacement and the peak stress were deÿned as indexes to estimate foot function.Results: It was found that foot function was a ected primarily by the deÿcit of the ÿrst to the third metatarsal bone. In comparison with the intact healthy foot, the peak displacement and the peak stress of the whole deÿcit of the ÿrst to the third metatarsal bone increased by 215 and 212%, respectively, while those of the half deÿcit increased by 165 and 205%, respectively. For the whole and the half deÿcit of the fourth to the ÿfth metatarsal bone, the values of the two indexes increased by 144 and 109%, and 137 and 103%, respectively. After reconstruction, the results showed that the stress-concentrated regions dispersed relatively, especially in heel, metatarsal heads and reconstructive bone block. The maximum displacement and stress of the deÿcit rebuilt by ilium were the minimums in comparison with the reconstructions with ÿbula and scapula.Conclusion: The reconstructed multi-metatarsal deÿcit can be analysed by ÿnite element method. The ilium was the preferred reparation material for the bone deÿcit.

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Vascularized Bone Graft from the Iliac Crest for the Treatment of Nonunion of the Proximal Part of the Scaphoid with an Avascular Fragment*

Cited by 122 publications

References 42 publications

Bone grafting the scaphoid nonunionA systematic review of 147 publications including 5 246 cases of scaphoid nonunion

Bone grafting the scaphoid nonunionA systematic review of 147 publications including 5 246 cases of scaphoid nonunion

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

Finite element analysis of metatarsal deficit and reconstruction using ilium, fibula and scapula

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