ePlasty: Vol. 14
Reconstruction of Scaphoid Nonunion Fractures of the Proximal One Third With a Vascularized Bone Graft From the Distal Radius
Frank Werdin, MD, Patrick Jaminet, MD, Beate Naegele, MD, Matthias Pfau, MD, and Hans-Eberhard Schaller, MD

Department for Hand, Plastic, Reconstructive Surgery, Burn Center, BG-Trauma Center, University of Tübingen, Tübingen, Germany

Correspondence: fwerdin@gmx.de
Keywords: scaphoid, nonunion, bone graft, vascularized, reconstruction

Objective: The treatment of proximal located scaphoid nonunion is a well-known and common problem. For these patients, we used a vascular pedicled bone graft of the distal radius. Methods: In the last 7 years, 75 patients were treated with the vascular pedicled bone graft. Retrospectively, patients' data, healing rates, and factors influencing scaphoid healing were analyzed. Results: The overall healing rate in cases with proximal located nonunions (n = 54) was approximately 70%. Out of these 54 patients, 47 patients showed avascular proximal fragments. Multivariate analysis showed no significant impact for the factors age, smoking, duration of disease, or previous operation. Conclusions: In our negative selected patient group, we were able to achieve good results with the usage of a pedicled vascularized bone graft of the distal radius. Our results indicate a fav .......