An Introspection on Vascularized bone transfers for Avascular Necrosis of Bones of Femoral Head and Scaphoid

Avascular necrosis of bone, due to various etiologies, is not an uncommon skeletal pathology seen in clinical practice. Treatment of these conditions includes treating the resultant pain, stiffness, and limitations of movement surgically with bone grafts both vascularized and non-vascularized and arthroplasty in most advanced stages.

In a duration of 2 years, five patients were treated for such pathologies using vascularized bones (pedicled or free). All of them were subjected to radioisotope (Technetium 99m) scan postoperatively to evaluate the viability of the transferred bones. The post-operative pain was assessed using visual analog scale (VAS) to assess the outcome of treatment by comparing the score before and after surgery.

All patients improved symptomatically as per the outcome assessment with VAS score with viability of the transferred bones as evidenced by radioisotope scan.

Vascularized bone transfer is indispensable in the treatment of avascular necrosis of bone and the complications thereof, and should always be offered primarily to younger patients especially.