Free-vascularized bone grafts for scaphoid non-unions viable as outpatient procedure?

Objective: To determine if free vascularized bone grafting procedures are considered safe to perform for outpatient treatment in the setting of scaphoid non-union. Setting: Utilizing The American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) scaphoid nonunion cases were isolated and investigated. Patients/Participants: A total of 50 patients with scaphoid fractures treated with vascularized bone graft were identified.  Intervention: Bone graft with microvascular anastomosis for closed fracture of the scaphoid Main Outcome Measurements: Length of hospital stay, acute (30 day) complication rates Results: The average length of hospital stay was 1.2 days and 18 patients (36%) were discharged the same day of surgery. There were no complications reported within the 30-day post-operative period. Conclusion: The reported early morbidity and mortality rates of free vascularized bone grafting in the setting of scaphoid fractures have been reported to be minimal. These rare early complications include superficial surgical site infections and pin site irritation. In this analysis, there were no reported adverse outcomes. Given the low risks for acute complications, vascularized bone transfer surgery in the setting of scaphoid nonunion can be considered safe and potentially cost effective to perform on an outpatient basis. Level of Evidence: IV Keywords: Scaphoid fracture; scaphoid nonunion; free vascularized bone graft; ambulatory surgery; outpatient surgery; cost effectiveness (J Ortho Business 2021 Oct 1;1(2):5-8)