Non-union after scaphoid fracture is a common complication. Controversy exists regarding the efficacy of vascularized bone graft (VBG) versus non-vascularized bone graft (NVBG) for scaphoid non-union. In the current meta-analysis, a comprehensive search of PubMed and the Cochrane Library database was done from inception to June 2024. We included randomized controlled trials (RCTs) and prospective comparative studies that reported outcomes following scaphoid non-union comparing VBG versus NVBG. Two reviewers independently extracted data and assessed the risk of bias. Any discrepancy was resolved by consensus and discussion with a third reviewer. We included five RCTs and one prospective comparative study. The combined odds ratio is 1.57 (95% CI: 0.87-2.86), favoring a higher union rate in the experimental group. The overall pooled mean difference of -1.40 (95% CI: -2.03 to -0.77) indicated that the VBG has a significantly shorter time to union compared to the NVBG. In conclusion, our results showed that VBG may be associated with an improved union rate and a decrease in union time, though no significant functional benefits.
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http://dx.doi.org/10.7759/cureus.77711 | DOI Listing |
Cureus
January 2025
Orthopaedics, Rajendra Institute of Medical Sciences, Ranchi, IND.
Non-union after scaphoid fracture is a common complication. Controversy exists regarding the efficacy of vascularized bone graft (VBG) versus non-vascularized bone graft (NVBG) for scaphoid non-union. In the current meta-analysis, a comprehensive search of PubMed and the Cochrane Library database was done from inception to June 2024.
View Article and Find Full Text PDFHand Surg Rehabil
February 2025
AOU di Modena - SC Chirurgia della Mano, Italy.
Most patients with post-traumatic and/or degenerative wrist arthritis present with pain and limitation of activities of daily living. Wrist denervation using a two-incision technique is an alternative to proximal row carpectomy and partial or total wrist arthrodesis. The purpose of this study was to evaluate whether two-incision denervation is a valid procedure for reducing pain in wrist arthritis of different etiologies.
View Article and Find Full Text PDFIntroduction: The goal of this work is to determine, using the analysis of our own patient group and current professional publications, in which cases fractures of the scaphoid waist can be treated conservatively by short-term plaster fixation with a low risk of non-union developing.
Material And Method: A group of 19 patients (17 men and 2 women) with the mean age 31 years (range 20-43, SD 7.3) with fractures of scaphoid waist were indicated for conservative treatment.
J Hand Ther
March 2025
Department of Plastic and Hand Surgery, Inselspital Bern, University of Bern, Bern, Switzerland.
Background: Non-invasiveness and comfort are crucial in the conservative management of distal radius and scaphoid fractures. While fiberglass casts are standard, three-dimensional (3D)-printed orthoses offer a promising alternative.
Purpose: To compare patient experiences, safety perceptions, and satisfaction between a 3D orthosis and fiberglass cast for distal radius or scaphoid fractures.
Hand Surg Rehabil
February 2025
Department of Hand Surgery, Grenoble Alpes University Hospital, 38000 Grenoble, France; TIMC Laboratory, Grenoble Alpes University, Pavillon Taillefer, 38700 La Tronche, France. Electronic address:
New surgical techniques for the treatment of scaphoid non-union, developed in the last two decades, now enable a healing rate of 80-90%. However, no consensus exists for the surgical treatment of non-union. On the other hand, regenerative medicine techniques have enriched the therapeutic armamentarium for non-union, especially in the lower limbs, with the use of autologous concentrated bone marrow injection using autologous osteogenic precursors to create a favorable microenvironment for bone healing.
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