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[Vascularized bone graft in carpal bone reconstruction]
C Mathoulin1, M Haerle, G Vandeputte
1Institut de la main, 6, square Jouvenet, 75016 Paris, France. mathoulin@wanadoo.fr
Annales De Chirurgie Plastique Et Esthetique
|February 8, 2005
Summary
This study demonstrates the effectiveness of vascularized bone grafts from the distal radius for carpal bone reconstruction. The technique achieved high union rates for scaphoid non-unions and successful revascularization in Kienbock
Area of Science:
- Orthopedic Surgery
- Vascularized Bone Grafting
- Hand Surgery
Background:
- Carpal bone reconstruction presents challenges in achieving adequate vascularization.
- Scaphoid non-unions and Kienbock's disease require reliable reconstructive techniques.
Purpose of the Study:
- To evaluate the efficacy of vascularized bone grafts from the distal radius for carpal bone reconstruction.
- To assess outcomes in patients with scaphoid non-unions and Kienbock's disease.
Main Methods:
- Cadaveric dissections identified the volar carpal artery originating from the radial artery.
- Vascularized bone grafts were harvested from the volar distal radius for 87 scaphoid non-unions and 22 Kienbock's disease cases.
- Radius shortening was combined with grafting for Kienbock's disease; MRI was used for assessment.
Main Results:
- Successful union was achieved in 92% of scaphoid non-union cases (80/87).
- Good revascularization and healing were observed in 74% of Kienbock's disease cases (16/22) via MRI.
- Lunate lesions were stabilized in 5 cases, with one failure requiring palliative treatment.
Conclusions:
- Vascularized bone grafting from the distal radius is a viable technique for carpal bone reconstruction.
- The procedure offers a single-approach solution with sufficient revascularization for scaphoid non-unions and Kienbock's disease.