Extremely longstanding neglected scaphoid nonunion with humpback deformity treated with a palmar radiocarpal artery vascularized bone graft: A report of two cases

JOS Case Reports Pub Date : 2023-12-01 Epub Date: 2023-07-21 DOI:10.1016/j.joscr.2023.07.002

Hiroo Kimura , Taku Suzuki , Noboru Matsumura , Kazuki Sato , Takuji Iwamoto

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Abstract

Background

Scaphoid nonunion (SN) with humpback deformity (HD) may be treated with varying approaches, and there is no consensus regarding the optimal method for longstanding neglected cases. We present two cases of extremely longstanding neglected SN with HD, both successfully treated with palmar radiocarpal artery (PRCA) vascularized bone grafts (VBGs).

Case presentation

Two patients, aged 55 and 58 years, who experienced injury 40 and 23 years prior, respectively, presented with neglected SN with HD and underwent surgery. Using a palmar approach, the nonunion site was decorticated and PRCA-VBGs were intercalated and fixed with headless screws. Partial union was confirmed by computed tomography within 3 months postoperatively, and satisfactory clinical and radiographic outcomes were observed at the final follow-up.

Conclusions

The method facilitated correction of HD with VBGs from the palmar side of the distal radius. PRCA-VBGs may be suitable for achieving bone union and deformity correction in extremely longstanding cases.

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掌桡腕动脉带血管骨移植物治疗长时间被忽视的座头畸形舟状骨不连:两例报告

背景:伴随座头畸形(HD)的舟状骨不连(SN)可以采用不同的治疗方法，对于长期被忽视的病例的最佳治疗方法尚无共识。我们报告了两例长期被忽视的SN伴HD，均通过掌桡腕动脉(PRCA)血管化骨移植(VBGs)成功治疗。2例患者，年龄55岁和58岁，分别在40年前和23年前经历过损伤，表现为被忽视的SN伴HD并接受了手术。采用掌侧入路，将骨不连部位去皮，置入PRCA-VBGs，并用无头螺钉固定。术后3个月计算机断层扫描证实部分愈合，最终随访临床和影像学结果满意。结论该方法可方便地从桡骨远端掌侧应用VBGs矫正HD。PRCA-VBGs可能适用于实现骨愈合和畸形矫正的极端长期病例。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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JOS Case Reports

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