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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.
Journal of Wrist Surgery
|January 23, 2026
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.
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.
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