Vascularized bone grafting and mini-acutrak fixation of scaphoid non-unions with avascular proximal pole
Por:
Lamas, C, Moldovan, R, Proubasta, I, Natera, L
Publicada:
1 sep 2011
Resumen:
Objectives. - We studied the use of vascularized bone graft as described by Zaidemberg et al. in combination with a fixation as described by Carter et al. in patients with scaphoid non-union and avascular proximal poles. We modified this method using a cannulated mini-acutrak screw.
Methods. - Between January 2006 and June 2010, we treated 12 male patients with symptomatic scaphoid non-union with avascular proximal poles. Their average age was 26 years (range 18-47 years). The average follow-up was 16 months (range 6-52 months). All the patients were assessed for any persistent pain including grade of pain, any restriction of daily activities, and osteoarthritis.
Results. - All patients achieved union within an average of 15 weeks (range 6-32 weeks). In all cases we encountered the 1,2 intercompartmental supraretinacular artery (1, 2 ICSRA) intraoperative. X-rays and CT showed a complete osseous union in all patients.
Conclusions. - We have found that the technique described which combines vascularized bone graft with cannulated mini-acutrak screw, is reliable and successful in treating patients with scaphoid non-unions with avascular poles. We prefer to use the vessel described by Zaidemberg et al. as the 1,2 ICSRA. If this vessel is occasionally absent (present in 94%), as noted by Sheetz et al., other pedicles may be used. (C) 2011 Elsevier Masson SAS. All rights reserved.
Filiaciones:
Lamas, C:
Autonomous Univ Barcelona, Hand Surg Unit, Dept Orthopaed Surg, Hosp Santa Creu & St Pau, Barcelona 08025, Spain
Moldovan, R:
Autonomous Univ Barcelona, Hand Surg Unit, Dept Orthopaed Surg, Hosp Santa Creu & St Pau, Barcelona 08025, Spain
Proubasta, I:
Autonomous Univ Barcelona, Hand Surg Unit, Dept Orthopaed Surg, Hosp Santa Creu & St Pau, Barcelona 08025, Spain
Natera, L:
Autonomous Univ Barcelona, Hand Surg Unit, Dept Orthopaed Surg, Hosp Santa Creu & St Pau, Barcelona 08025, Spain
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