Vascularized pronator quadratus pedicled bone grafting versus iliac crest bone grafting in the treatment of scaphoid nonunion: a retrospective study

IF 0.2 Q4 ORTHOPEDICS

Current Orthopaedic Practice Pub Date : 2023-07-06 DOI:10.1097/BCO.0000000000001225

Farshad Zandrahimi, Maryam Aazami, Alireza Sarhadi Zade, A. Saied

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Abstract

Background: Vascularized pronator quadratus pedicled bone grafting is a viable procedure for the treatment of scaphoid nonunion. However, its superiority over iliac crest bone grafting is unknown. In this study, we compare the union rate and outcomes of these procedures in the treatment of scaphoid nonunion. Methods: The medical profiles of the patients with scaphoid nonunion that were treated with either pronator quadratus pedicled bone grafting (n=23) or iliac crest bone grafting procedure (n=31) were retrospectively reviewed. Patients with avascular necrosis of the scaphoid and those with the involvement of the proximal pole were excluded. The outcome measures were the union rate and time, active wrist range of motion, pinch, and grip strength. Results: The mean age of the patients was 30±8.1 yr. Bony union was achieved in all patients of the study groups. The mean time to union was 9.1±2.8 wk in the pronator quadratus group and 8.7±3.5 wk in the iliac crest groups (P=0.14). The mean active flexion, extension, radial deviation, ulnar deviation, pinch, and grip strength of the involved wrist averaged 87.3%, 86.2%, 80.2%, 89.1%, 84.3%, and 85.6% of the contralateral wrist in the pronator quadratus group and 85.5%, 87%, 77.8%, 85.1%, 88.8%, and 87.8% of the contralateral wrist in the iliac crest group, respectively. These differences were not statistically significant. Conclusion: Pronator quadratus pedicled bone grafting provides a similar union rate and outcomes compared to the iliac crest bone grafting in the treatment of scaphoid nonunion. Level of Evidence: IV

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带血管旋前方肌带蒂植骨与髂骨植骨治疗舟状骨不连的回顾性研究

背景：带血管旋前方肌蒂骨移植是治疗舟骨不连的可行方法。然而，它相对于髂骨移植的优越性尚不清楚。在本研究中，我们比较了这些手术治疗舟骨不连的愈合率和结果。方法：回顾性分析采用旋方肌带蒂骨移植（n=23）或髂嵴骨移植术（n=31）治疗腕舟骨不连的临床资料。排除舟骨缺血性坏死患者和累及近端骨的患者。结果指标包括愈合率和时间、活动手腕活动范围、握力和握力。结果：患者的平均年龄为30±8.1岁。研究组的所有患者都实现了骨愈合。旋方组和髂嵴组的平均愈合时间分别为9.1±2.8周和8.7±3.5周（P=0.014）。旋方组对侧手腕的平均主动屈曲、伸展、径向偏移、尺骨偏移、挤压和握力分别为87.3%、86.2%、80.2%、89.1%、84.3%和85.6%和85.5%、87%、77.8%、85.1%、88.8%，髂嵴组分别占对侧手腕的87.8%。这些差异在统计学上并不显著。结论：旋方肌蒂骨移植与髂嵴骨移植治疗舟骨不连具有相似的愈合率和疗效。证据级别：IV

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来源期刊

Current Orthopaedic Practice ORTHOPEDICS-

CiteScore

0.60

自引率

0.00%

发文量

107

期刊介绍： Lippincott Williams & Wilkins is a leading international publisher of professional health information for physicians, nurses, specialized clinicians and students. For a complete listing of titles currently published by Lippincott Williams & Wilkins and detailed information about print, online, and other offerings, please visit the LWW Online Store. Current Orthopaedic Practice is a peer-reviewed, general orthopaedic journal that translates clinical research into best practices for diagnosing, treating, and managing musculoskeletal disorders. The journal publishes original articles in the form of clinical research, invited special focus reviews and general reviews, as well as original articles on innovations in practice, case reports, point/counterpoint, and diagnostic imaging.