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Arch Hand Microsurg > Volume 19(4); 2014 > Article
Journal of the Korean Society for Surgery of the Hand 2014;19(4):173-179.
Published online December 30, 2014.
DOI: https://doi.org/10.12790/jkssh.2014.19.4.173   
Scaphoid Nonunions Treated with 1, 2-Intercompartment Supraretinacular Artery Pedicled Vascularized Bone Graft and Headless Compression Screw Fixation
Dong Hyun Kim, Yang Guk Chung, Seung Han Shin, Ho Jin Gil, Jin Woo Kang, Han Seok Cho
Department of Orthopedic Surgery, The Catholic University of Korea College of Medicine, Seoul, Korea. ygchung@catholic.ac.kr
Received: 19 November 2014   • Revised: 8 December 2014   • Accepted: 9 December 2014
The purpose of this study was to evaluate the clinical results of scaphoid nonunions treated with 1, 2-intercompartment supraretinacular artery (ICSRA) pedicled vascularized bone grafting (VBG) and headless compression screw fixation.

Since August 1, 2005, 11 scaphoid nonunions with avascular necrosis or bone marrow edema of proximal fragments were managed with 1, 2-ICSRA pedicled VBG combined with headless compression screw fixation. The mean age was 37.1 years (range, 21-66 years). 8 patients had avascular necrosis (AVN) of proximal fragments and 3 patients had bone marrow edema in proximal fragments. Serial radiographic evaluations were performed in every 4-8 weeks for bone union and follow up computed tomography scanning were checked in 8 patients.

Bone unions were obtained in all 11 patients at 4.9 months (range, 3-9 months) after operation. At last follow up, the average range of motion was 82.5% and the grip power was 84.1% compared to the contralateral side. The mean New York Orthopaedic Hospital wrist score at last follow up was 83.2 (range, 58.1-93.3).

Combined 1, 2-ICSRA pedicled VBG and headless compression screw fixation were reliable methods for managements of scaphoid nonunions even with AVN at proximal fragments.

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