Treatment of failed scaphoid nonunion fixation using free medial femoral condyle vascularized bone grafting.

IF 1.8 Q2 ORTHOPEDICS
SICOT-J Pub Date : 2023-01-01 DOI:10.1051/sicotj/2023004
Islam Koriem, Aly Abdalla Agina, Ahmed K El Ghazawy
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引用次数: 0

Abstract

Background: Nonunion in scaphoid fractures may be considered a devastating problem. Union failure results in scaphoid deformity, resorption, and bone loss. Failed previous fixation decreases remaining bone stock and makes it more difficult to achieve union. Free vascularized graft represents a good option to achieve scaphoid union with revision fixation. Our study aims at the assessment of the management of scaphoid fractures non-union after failed previous fixation with the use of a free vascularized graft from the medial femoral condyle.

Methods: This is a retrospective study including 16 cases with persistent scaphoid nonunion after previous fixation managed by vascularized medial femoral condyle grafts. The mean follow-up was 24 months. Previous surgical attempts and nonunion duration were noted. We evaluated the union rate, together with ROM, Scapholunate angles and pain scores.

Results: the union was achieved in 13 of 16 cases. Pain improved in all patients (10/16 complete relief). Wrist ROM at follow-up was an average of 50° flexion 48° extension. There was no change in the relationship between lunate and scaphoid with an average angle of 37.5° preoperative and 38° postoperative.

Conclusion: Free vascularized MFC grafts are considered a reliable method to treat persistent nonunion of scaphoid fractures after failed previous operations. Short-term follow-up data showed considerable union rates with adequate pain relief and satisfactory ROM.

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游离股骨内侧髁带血管骨移植治疗舟状骨不连固定失败。
背景:舟状骨骨折不愈合可能被认为是一个毁灭性的问题。愈合失败导致舟状骨畸形、骨吸收和骨丢失。先前固定失败会减少剩余骨存量,使骨愈合更加困难。带血管的游离移植物是一个很好的选择,以实现舟骨愈合翻修固定。我们的研究目的是评估使用股骨内侧髁带血管的游离移植物对先前固定失败后舟状骨骨折不愈合的处理。方法:回顾性分析16例经带血管的股内侧髁移植物固定后舟骨不愈合的病例。平均随访时间为24个月。记录以前的手术尝试和不愈合持续时间。我们评估愈合率、关节活动度、舟月角和疼痛评分。结果:16例患者中13例成功愈合。所有患者的疼痛均有所改善(10/16完全缓解)。随访时腕关节活动度平均为屈曲50°48°。月骨与舟骨的关系没有变化,术前和术后的平均角度分别为37.5°和38°。结论:游离带血管的MFC移植是治疗舟状骨骨折术后持续不愈合的可靠方法。短期随访数据显示相当高的愈合率,足够的疼痛缓解和满意的ROM。
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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来源期刊
SICOT-J
SICOT-J ORTHOPEDICS-
CiteScore
3.20
自引率
12.50%
发文量
44
审稿时长
14 weeks
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