Vascularized Versus Non-vascularized Bone Grafting for Scaphoid Non-union: A Meta-Analysis

Non-union after scaphoid fracture is a common complication. Controversy exists regarding the efficacy of vascularized bone graft (VBG) versus non-vascularized bone graft (NVBG) for scaphoid non-union. In the current meta-analysis, a comprehensive search of PubMed and the Cochrane Library database was done from inception to June 2024. We included randomized controlled trials (RCTs) and prospective comparative studies that reported outcomes following scaphoid non-union comparing VBG versus NVBG. Two reviewers independently extracted data and assessed the risk of bias. Any discrepancy was resolved by consensus and discussion with a third reviewer. We included five RCTs and one prospective comparative study. The combined odds ratio is 1.57 (95% CI: 0.87-2.86), favoring a higher union rate in the experimental group. The overall pooled mean difference of -1.40 (95% CI: -2.03 to -0.77) indicated that the VBG has a significantly shorter time to union compared to the NVBG. In conclusion, our results showed that VBG may be associated with an improved union rate and a decrease in union time, though no significant functional benefits.