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Bone Graft and Fixation Options in the Surgical Management of Scaphoid Nonunion.
J Am Acad Orthop Surg
October 2024
From the Department of Orthopedic Surgery, New York University Langone Health, New York, NY.
Article Synopsis
- Scaphoid nonunions are challenging for hand surgeons due to the scaphoid's poor blood supply, leading to the need for internal fixation and bone grafts for treatment.
- Various bone graft options exist depending on the patient's condition, blood supply, and any deformities, including nonvascularized autologous grafts from different body areas and vascularized grafts for blood supply concerns.
- The review emphasizes the importance of using bone grafts to enhance internal fixation, promote healing, and restore alignment in cases of scaphoid nonunions.
Proximal Scaphoid Reconstruction Techniques Comparison of Three Techniques for Proximal Scaphoid Recontruction.
J Wrist Surg
October 2024
Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
Article Synopsis
- - This study compares three graft options— costo-osteochondral autograft, vascularized medial femoral trochlear autograft, and proximal hamate autograft—for reconstructing the nonunions of the proximal pole of the scaphoid bone.
- - Researchers used wireless sensors on the wrist to analyze carpal kinematics through cyclical movements, testing each reconstruction condition to evaluate differences in joint motion.
- - The findings indicate that there are no significant differences in the motion of two specific wrist joints (scapholunate and lunocapitate) during various wrist movements across the three graft types, suggesting minimal impact on carpal kinematics from the type of graft used.
A Comparison of Rib Osteochondral Graft to Medial Femoral Trochlear Osteocartilaginous Graft for the Salvage of the Fragmented Scaphoid Proximal Pole: A Single-Center Experience with Minimum 2-Year Follow-Up.
J Wrist Surg
August 2024
Victorian Hand Surgery Associates, Fitzroy, Australia.
Article Synopsis
- The study compares two surgical methods (costal-osteochondral graft (COG) and medial femoral trochlea (MFT) graft) for treating fragmented fractures of the scaphoid with over two years of follow-up.
- Both methods showed similar outcomes in terms of pain and wrist function, but there was a distinct radiographic finding where COG patients had evidence of arthritis, while MFT patients did not.
- MFT patients experienced knee pain as a complication, while COG patients faced the risk of developing wrist arthritis over time.
Clinical Results of Nonvascularized Metatarsal Articular Bone Grafting for Osteochondral Defects of the Radiocarpal and Distal Radioulnar Joint.
J Wrist Surg
April 2024
Department of Plastic, Reconstructive and Hand Surgery, University Medical Centre Utrecht, Utrecht, The Netherlands.
Treatment of post-traumatic osteochondral defects in the radiocarpal and distal radioulnar joint with nonvascularized metatarsal articular bone grafting is an option to restore the joint (cartilage) surface and wrist function. To evaluate the clinical midterm results of 10 consecutive patients who were treated with a nonvascularized metatarsal bone graft for cartilage bone defects of the lunate facet, scaphoid facet, sigmoid notch, or the radial part of the ulnar head. Patients with isolated osteochondral defects of the lunate facet, scaphoid facet, sigmoid notch, or radial part of the ulnar head, respectively, as a result of wrist trauma were retrospectively identified in a prospectively collected database.
View Article and Find Full Text PDFBiomechanics of Proximal Hamate Autograft in Scaphoid Nonunion.
J Wrist Surg
December 2023
Department of Orthopaedics and Sports Medicine, University of Washington Medical Center, Seattle, Washington.
Article Synopsis
- Proximal scaphoid fractures are challenging to treat due to risks like nonunions and avascular necrosis from its blood supply; using the proximal hamate as an autograft for reconstruction is explored in this study.
- The study involved testing cadaveric forearms to measure changes in contact pressure and area in the radioscaphoid joint after autograft surgery, finding that while pressures remained similar, contact areas decreased post-surgery.
- Results indicate that while the hamate autograft alters the contact area due to its shape, it does not significantly change peak contact pressures at the radioscaphoid joint, suggesting this could be a viable reconstruction option.
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