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Spongy Bone

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All bones comprise an outer layer of compact bone, and an interior made up of spongy bone tissue, also called cancellous or trabecular bone. In long bones, spongy bone tissue is mainly found in the interior of the epiphyses (broad ends of the bone).
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Most bones contain compact and spongy osseous tissue, but their distribution and concentration vary based on the bone's overall function.
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Aging and its effect on bone remodeling is the most common cause of bone disorders. In young and healthy people, bone deposition and resorption happen at an equal rate to maintain optimal bone health.
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The hyoid bone is a small U-shaped bone located in the upper neck at the level of the inferior mandible, with its tips pointing posteriorly. It does not directly articulate with any other bone in the body. The hyoid acts as the attachment site for the tongue, the larynx, and the pharynx. It is held in position by a series of small muscles attached from above or below. These muscles help to move the hyoid up/down or forward/back in coordination with movements of the tongue, larynx, and pharynx...
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Bone Structure01:55

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Within the skeletal system, the structure of a bone, or osseous tissue, can be exemplified in a long bone, like the femur, where there are two types of osseous tissue: cortical and cancellous.
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Bone remodeling is a continuous and balanced process of bone resorption by osteoclasts and bone formation by osteoblasts. In adults, it helps maintain bone mass and calcium homeostasis. While mechanical stress can stimulate turnover as part of the normal maintenance and reparative process, several hormones also regulate bone remodeling.
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Nonvascularized Bone Grafting for Scaphoid Nonunion.

Viviana M Serra López1, Scott W Wolfe1

  • 1Department of Hand and Upper Extremity Surgery, Hospital for Special Surgery, New York, New York.

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|January 23, 2026
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Summary

Non-vascularized bone grafts effectively treat scaphoid nonunions, with the hybrid Russe procedure showing promising results. This surgical technique aids in restoring carpal alignment and bone defects for scaphoid fracture healing.

Keywords:
hybrid Russenonvascularized bone graftscaphoid non-union

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Area of Science:

  • Orthopedic surgery
  • Hand surgery
  • Traumatology

Background:

  • Scaphoid nonunions require stable fixation, carpal alignment restoration, and bone defect reconstruction.
  • Bone defects can be managed with vascularized or non-vascularized bone grafts, based on surgeon preference.

Purpose of the Study:

  • To describe the use of non-vascularized bone grafts for scaphoid nonunions.
  • To examine reported outcomes of non-vascularized bone grafts.
  • To detail the hybrid Russe procedure for scaphoid nonunion management.

Main Methods:

  • The hybrid Russe procedure uses a volar distal radius corticocancellous strut.
  • Restores scaphoid and lunate alignment.
  • Fixation is completed with a headless compression screw.

Main Results:

  • The hybrid Russe procedure achieved healing in 17 scaphoid fracture nonunions.
  • Average healing time was 15 weeks.
  • No significant difference in union rates between graft types is evident in literature.

Conclusions:

  • Non-vascularized bone grafts are a viable option for scaphoid nonunions.
  • The hybrid Russe procedure effectively treats scaphoid nonunions with flexion deformities.
  • Surgeon discretion guides graft choice when the proximal scaphoid pole is salvageable.