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Scaphoid Nonunions: Local Vascularized Bone Flaps.

Justin C McCarty1, Ryoko Hamaguchi1, Kyle R Eberlin1

  • 1Division of Plastic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Hand Clinics
|November 18, 2023
PubMed
Summary
This summary is machine-generated.

Untreated scaphoid nonunions can lead to advanced collapse. Local vascularized bone flaps (VBFs) offer a high union rate for scaphoid fractures, avoiding complex microsurgery.

Keywords:
Local vascularized bone flapsScaphoid nonunionVascularized bone graft/Flap

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Area of Science:

  • Orthopedic surgery
  • Hand surgery
  • Bone healing

Background:

  • Scaphoid nonunions can progress to debilitating conditions like scaphoid nonunion advanced collapse.
  • Various surgical techniques exist for scaphoid nonunion treatment.
  • Vascularized bone flaps (VBFs) show promise in improving bone union times.

Purpose of the Study:

  • To evaluate the efficacy of local vascularized bone flaps (VBFs) in treating scaphoid nonunions.
  • To highlight the advantages of VBFs over nonvascularized grafts.
  • To emphasize the accessibility of VBFs for hand surgeons.

Main Methods:

  • Review of techniques for scaphoid nonunion treatment.
  • Focus on local pedicled vascularized bone flaps (VBFs).
  • Comparison of VBFs with nonvascularized grafts regarding union rates and surgical complexity.

Main Results:

  • Vascularized bone flaps (VBFs) demonstrate faster union times compared to nonvascularized grafts.
  • Local VBFs do not necessitate microsurgical anastomoses, simplifying the procedure.
  • High union rates, ranging from 90% to 100%, are achievable with appropriately selected patients and local VBFs.

Conclusions:

  • Local vascularized bone flaps (VBFs) are an effective treatment for scaphoid nonunions.
  • The technique is accessible to hand surgeons due to its local nature and lack of need for microsurgery.
  • VBFs represent a valuable option for achieving high union rates in scaphoid nonunion management.