Yıl: 2019 Cilt: 8 Sayı: 3 Sayfa Aralığı: 151 - 159 Metin Dili: İngilizce DOI: 10.5455/handmicrosurg.25576 İndeks Tarihi: 31-10-2020

Results of the 4-5 ECA vascularized pedicle bone grafting in avascular pseudoarthroses of the scaphoid proximal pole

Öz:
Objective: The scaphoid bone is the most injured carpal bone and is the cause of severe wrist dysfunction seen in nonunioncases. The probability of avascular necrosis is very high especially in fractures of the proximal pole, due to the retrogradeblood flow in the region. In these cases, vascularized pedicle bone grafts, with high rates of union, is a good alternative tothe conventional techniques. In this study, we present the results of vascularized bone grafting with grafts harvested fromthe 4-5 extensor compartment artery (ECA) and fixation with the Herbert screw in patients with avascular pseudoarthrosesof the scaphoid proximal pole.Methods: Fifteen patients who presented to our clinic due to nonunion of the scaphoid and who were applied vascularizedpedicle bone grafts harvested from the ECA between 2006 and 2015 were included in the study. The mean age of the patients was 30.1 (19-42) and all patients were male. Patients were followed up for an average period of 22.7 (18-56) months.Union in the patients were evaluated with the preoperative and postoperative wrist ranges of motion. VAS (visual analogscale) and, for functional evaluation, the Turkish version of the Quick-DASH scale were used.Results: Union was achieved in all patients after a mean period of 8.2 (6-10) weeks. The most significant improvementsafter surgery were detected in the VAS and functional Quick-DASH scores. No significant improvement was observed inwrist contractures. Other than the hematoma in one patient, no complication was observed.Conclusion: In cases of nonunion of the scaphoid proximal pole fractures accompanied by avascular necrosis, pediclegrafts from the 4-5 ECA offer high rates of union and improvement in the pain and functional scores of the patients. Level ofevidence Level IV, therapeutic study.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Mack GR, Bosse MJ, Gelberman RH, Yu E. The natural history of scaphoid nonunion. J Bone Joint Surg Am 1984;66:504-9.
  • 2. Schuind F, Haentjens P, Van Innis F. Prognostic factors in the treatment of carpal scaphoid nonunions. J Hand Surg 1999;24A:761–76.
  • 3. Alluri RK, Yin C, Iorio ML, Leland H, Wong J, Patel K. Vascularized Bone Grafting in Scaphoid Nonunion : A Review of Patient Centered Outcomes. Hand (NY) 2017;12:127-34.
  • 4. Shin AY, Bishop AT. Pedicled vascularized bone grafts for disorders of the carpus: scaphoid nonunion and Kienböck’s disease. J Am Acad Orthop Surg 2002;10:210-6.
  • 5. Krug EG, Sharma GK, Lozano R. The global burden of injuries. Am J Public Health 2000;90:523-6.
  • 6. Ross CE, Mirowsky J. Does employment affect health ? J Health Soc Behav 1995;36:230-43.
  • 7. Kuschner SH, Lane CS, Brien WW, Gellman H. Scaphoid fractures and scaphoid nonunion. Diagnosis and treatment. Orthop Rev 1994;23:861–71.
  • 8. Steinmann SP, Bishop AT, Berger RA. Use of the 1,2 intercompartmental supraretinacular artery as a vascularized pedicle bone graft for difficult scaphoid nonunion. J Hand Surg Am 2002;27:391–401.
  • 9. Sotereanos DG, Darlis NA, Dailiana ZH, Sarris IK, Malizos KN. A capsular based vascularized distal radius graft for proximal pole scaphoid pseudoarthrosis. J Hand Surg Am 2006;31:580-7.
  • 10. Zaidemberg C, Siebert JW, Angrigiani C. A new vascularized bone graft for scaphoid nonunion. J Hand Surg 1991;16A:474– 8.
  • 11. Rizzo M, Moran SL. Vascularized bone grafts and their applications in the treatment of carpal pathology. Semin Plast Surg 2008;22:213-27.
  • 12. Cooney WP, Dobyns JH, Linscheid RL. Nonunion of the scaphoid: analysis of the results from bone grafting. J Hand Surg Am 1980;5:343–54.
  • 13. Merrell GA, Wolfe SW, Slade JF III. Treatment of scaphoid nonunions: quantitative meta-analysis of the literature. J Hand Surg Am 2002;27:685–91.
  • 14. Ribak S, Medina C, Mattar R Jr, Ulson HJ, Etchebehere M. Treatment of scaphoid nonunion with vascularised and nonvascularised dorsal bone grafting from the distal Radius. Int Orthop 2010;34:683-8.
  • 15. Bishop AT. Vascularized pedicle grafts from the dorsal distal radius: design and application for carpal pathology. In: Saffar P, Amadio PC, Foucher G, (eds.) Current Practice in Hand Surgery. Martin Dunitz Ltd, London, 1997:307–13.
  • 16. Sunagawa T, Bishop AT, Muramatsu K. Role of conventional and vascularized bone grafts in scaphoid nonunion with avascular necrosis: a canine experimental study. J Hand Surg 2000;25A:849–59.
  • 17. Sheetz KK, Bishop AT, Berger RA. The arterial blood supply of the distal radius and its potential use in vascularized pedicled bone grafts. J Hand Surg 1995;20A:902–14.
  • 18. Özalp T, Öz Ç, Kale G, Erkan S. Scaphoid nonunion treated with vascularised bone graft from dorsal Radius. Injury 2015;46 (Suppl 2):S47-52.
  • 19. Steinmann SP, Bishop AT, Berger RA. Use of the 1,2 intercompartmental supraretinacular artery as a vascularized pedicle bone graft for difficult scaphoid nonunion. J Hand Surg 2002;27A:391-401.
  • 20. Uerpairojkit C, Leechavengvongs S, Witoonchart K. Primary vascularized distal radius bone graft for nonunion of the scaphoid. J Hand Surg 2000;25B:266–70.
  • 21. Tsai TT, Chao EK, Tu YK, Chen AC, Lee MS, Ueng SW. Management of scaphoid nonunion with avascular necrosis using 1,2-intercompartmental supraretinacular arterial bone grafts. Chang Gung Med J 2002;25:321–8.
  • 22. Boyer MI, von Schroeder HP, Axelrod TS. Scaphoid nonunion with avascular necrosis of the proximal pole. Treatment with a vascularized bone graft from the dorsum of the distal radius. J Hand Surg Br 1998;23:686–90.
  • 23. Straw RG, Davis TR, Dias JJ. Scaphoid nonunion: treatment with a pedicled vascularized bone graft based on the 1,2 intercompartmental supraretinacular branch of the radial artery. J Hand Surg Br 2002;27:413.
  • 24. Chang MA, Bishop AT, Berger RA. The outcomes and complications of 1,2 intercompartmental supraretinacular artery pedicled vascularized bone grafting of scaphoid nonunions. J Hand Surg Am 2006;31:387–96.
  • 25. Christodoulou LS, Kitsis CK, Chamberlain ST. Internal fixation of scaphoid nonunion : a comparative study of three methods. Injury 2001;32:625-30.
  • 26. Straw RG, Davis TR, Dias JJ. Scaphoid nonunion : treatment with pedicled vascularised bone graft based on the 1,2 intercompartmental supraretinacular branch of the radial artery. J Hand Surg Br 2002;27:413.
  • 27. Chang MA, Bishop AT, Moran SL, Shin AY. The outcomes and complications of 1,2-intercompartmental supraretinacular artery pedicled vascularized bone grafting of scaphoid nonunions. J Hand Surg Am 2006;31:387-96.
  • 28. Dinah AF, Vickers RH. Smoking increases failure rate of operation for established non-union of the scaphoid bone. Int Orthop 2007;31:503-5.
  • 29. Little CP, Burston BJ, Hopkinson-Woolley J, Burge P. Failure of surgery for scaphoid nonunion is associated with smoking. J Hand Surg Br 2006;31:252-5.
  • 30. Waitayawinyu T, McCallister WV, Katolik LI Schlenker JD, Trumble TE. Outcome after vascularized bone grafting of scaphoid nonunions with avascular necrosis. J Hand Surg Am 2009;34:387-94.
  • 31. Boyer MI, Von Schroeder HP, Axelrod TS. Scaphoid nonunion with avascular necrosis of the proximal pole: treatment with a vascularized bone graft from the dorsum of the distal radius. J Hand Surg 1998;23B:686–90.
APA SARI A, OZCELİK B (2019). Results of the 4-5 ECA vascularized pedicle bone grafting in avascular pseudoarthroses of the scaphoid proximal pole. , 151 - 159. 10.5455/handmicrosurg.25576
Chicago SARI Abdulkadir,OZCELİK Bulent Results of the 4-5 ECA vascularized pedicle bone grafting in avascular pseudoarthroses of the scaphoid proximal pole. (2019): 151 - 159. 10.5455/handmicrosurg.25576
MLA SARI Abdulkadir,OZCELİK Bulent Results of the 4-5 ECA vascularized pedicle bone grafting in avascular pseudoarthroses of the scaphoid proximal pole. , 2019, ss.151 - 159. 10.5455/handmicrosurg.25576
AMA SARI A,OZCELİK B Results of the 4-5 ECA vascularized pedicle bone grafting in avascular pseudoarthroses of the scaphoid proximal pole. . 2019; 151 - 159. 10.5455/handmicrosurg.25576
Vancouver SARI A,OZCELİK B Results of the 4-5 ECA vascularized pedicle bone grafting in avascular pseudoarthroses of the scaphoid proximal pole. . 2019; 151 - 159. 10.5455/handmicrosurg.25576
IEEE SARI A,OZCELİK B "Results of the 4-5 ECA vascularized pedicle bone grafting in avascular pseudoarthroses of the scaphoid proximal pole." , ss.151 - 159, 2019. 10.5455/handmicrosurg.25576
ISNAD SARI, Abdulkadir - OZCELİK, Bulent. "Results of the 4-5 ECA vascularized pedicle bone grafting in avascular pseudoarthroses of the scaphoid proximal pole". (2019), 151-159. https://doi.org/10.5455/handmicrosurg.25576
APA SARI A, OZCELİK B (2019). Results of the 4-5 ECA vascularized pedicle bone grafting in avascular pseudoarthroses of the scaphoid proximal pole. Hand and Microsurgery, 8(3), 151 - 159. 10.5455/handmicrosurg.25576
Chicago SARI Abdulkadir,OZCELİK Bulent Results of the 4-5 ECA vascularized pedicle bone grafting in avascular pseudoarthroses of the scaphoid proximal pole. Hand and Microsurgery 8, no.3 (2019): 151 - 159. 10.5455/handmicrosurg.25576
MLA SARI Abdulkadir,OZCELİK Bulent Results of the 4-5 ECA vascularized pedicle bone grafting in avascular pseudoarthroses of the scaphoid proximal pole. Hand and Microsurgery, vol.8, no.3, 2019, ss.151 - 159. 10.5455/handmicrosurg.25576
AMA SARI A,OZCELİK B Results of the 4-5 ECA vascularized pedicle bone grafting in avascular pseudoarthroses of the scaphoid proximal pole. Hand and Microsurgery. 2019; 8(3): 151 - 159. 10.5455/handmicrosurg.25576
Vancouver SARI A,OZCELİK B Results of the 4-5 ECA vascularized pedicle bone grafting in avascular pseudoarthroses of the scaphoid proximal pole. Hand and Microsurgery. 2019; 8(3): 151 - 159. 10.5455/handmicrosurg.25576
IEEE SARI A,OZCELİK B "Results of the 4-5 ECA vascularized pedicle bone grafting in avascular pseudoarthroses of the scaphoid proximal pole." Hand and Microsurgery, 8, ss.151 - 159, 2019. 10.5455/handmicrosurg.25576
ISNAD SARI, Abdulkadir - OZCELİK, Bulent. "Results of the 4-5 ECA vascularized pedicle bone grafting in avascular pseudoarthroses of the scaphoid proximal pole". Hand and Microsurgery 8/3 (2019), 151-159. https://doi.org/10.5455/handmicrosurg.25576