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Updated: May 2, 2026
Vascularized Composite Hand Allograft Procurement and Preparation for Distal and Proximal Forearm Allotransplantation: A Stepwise Approach
Published on: May 23, 2025
[Is non-vascularized autografting in the proximal scaphoid nonunions ineffective?]
Ahmet Pişkin1, Alper Cıraklı, Murat Erdoğan
1Department of Orthopedics and Traumatology, Medical Faculty of Ondokuz Mayıs University, 55139 Kurupelit, Samsun, Turkey. piskinahmet@gmail.com.
Objectives:
In this study, we aimed to evaluate the results of proximal scaphoid non-union treated with non-vascularized bone grafting and screw fixation.
Patients And Methods:
Thirteen patients who were treated surgically for proximal scaphoid non-union with a minimum of one-year follow-up in our clinic were evaluated. Wrist movements were measured by standard goniometry and muscle strength by hand dynamometry. Non-union was classified radiologically according to the Schernberg classification, while functional assessment was performed based on the Herbert-Fisher Grading System and the Mayo Clinic Modified Wrist Scoring System.
Results:
The mean follow-up period was 14 months (range, 12 to 40 months). Full union was observed in eight of 13 patients (61.5%). The mean time to union was 16 (range, 12 to 40) weeks. There was no loss of function of more than 10% compared to the healthy hand in the cases with full union. Postoperative mean grip strength was 37.3±3.0 kg. The rates of excellent and good results were 61.5%, moderate and poor results were 38.5% according to the Herbert-Fisher classification and the mean Mayo score was 80±13.
Conclusion:
We obtained no satisfactory results in patients treated with non-vascularized bone grafting and screw fixation for proximal scaphoid non-unions. We suggest that grafting should be carried out in selected cases due to the adverse effects of open techniques and bone grafting on vascularity of scaphoid bone.
