Surgical Treatment of Scaphoid Non-Union in Adolescents: A Modified Vascularized Bone Graft Technique

Background: Although adolescents are at a lower risk of developing scaphoid non-union than adults, this complication is not uncommon in younger patients. The current gold standard for surgical treatment is non-vascularized bone grafting from the iliac crest or distal radius, and it is often considered the first-line option. However, non-union can persist in 10-20% of cases, and failure rates can reach up to 50% when the proximal pole is necrotic. Methods: We evaluated a modified vascularized bone graft surgical technique in selected adolescent patients, with the goal of avoiding growth-related complications. Our experience is based on three cases of scaphoid non-union treated surgically between June 2019 and June 2022. Results and Conclusions: The modified surgical technique has shown promising results in the selected cases and carries no risk of donor site morbidity. It enables preservation of severely compromised scaphoid bones, prevents early-onset wrist osteoarthritis, and facilitates the return to sports activities for young patients.