Clinical and radiological results of the vascularized medial femoral condyle graft for scaphoid non-union.
Arch Orthop Trauma Surg
; 140(6): 835-842, 2020 Jun.
Article
in En
| MEDLINE
| ID: mdl-32124031
ABSTRACT
INTRODUCTION:
This study evaluated the use of a free vascularized bone graft with and without cartilage from the medial femoral condyle (MFC) in patients with recalcitrant scaphoid non-union, with a special focus on union rates and the osteochondral graft for proximal pole destruction. MATERIALS ANDMETHODS:
Thirty-eight avascular scaphoid non-unions in 37 patients who were treated with a free osteoperiosteal or osteochondral MFC graft were retrospectively evaluated (mean follow-up 16 months). Bone union, the scapholunate and the radiolunate angles were evaluated on X-ray images. The range of motion, grip strength, VAS, DASH and PRWE scores were evaluated clinically.RESULTS:
The overall union rate was 95%. Bone union was achieved in 27 out of 29 (93%) scaphoids treated with a free osteoperiosteal MFC grafts and in 9 out of 9 (100%) scaphoids treated with a free osteochondral MFC graft. The range of motion remained almost unchanged, while grip strength increased significantly (34 kg vs. 44 kg) and the VAS (22-5), DASH (59-19) and PRWE (62-30) score decreased significantly. The scapholunate (71°-65°) and radiolunate (28°-18°) angle decreased. No major donor site morbidity was observed. Postoperative complications were observed in eight cases (21%).CONCLUSIONS:
The vascularized medial femoral bone graft leads to a good functional outcome in the treatment of scaphoid non-unions. The graft provides adequate blood supply and structural stability to the scaphoid. A proximal pole destruction can be replaced using an osteochondral graft with promising short-term results preventing carpal osteoarthritis and collapse.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Bone Transplantation
/
Scaphoid Bone
/
Femur
Type of study:
Observational_studies
Limits:
Humans
Language:
En
Journal:
Arch Orthop Trauma Surg
Year:
2020
Document type:
Article
Affiliation country: