Technique: vascularized bone grafts from the volar distal radius to treat scaphoid nonunion

The use of vascularized bone grafts to treat scaphoid nonunion has been proposed by various investigators. We examined the blood supply to the palmar surface of the distal radius in 40 fresh cadavers that were injected with a colored latex solution and determined that the radial portion of the palmar carpal arterial arch can serve as a pedicle for vascularized grafts. Scaphoid nonunions with a humpback deformity can be corrected by harvesting a wedge of vascularized bone from the palmar cortex of the distal radius, providing easier access to the scaphoid deformity compared with the use of dorsal distal radius vascularized grafts. We also review our series of 72 patients treated by this technique.