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Journal of Hand Surgery (European Volume)
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Historical Article

Treatment of Scaphoid Non-Unions by a Palmar Approach with Vascularised Bone Graft Harvested from the Thumb

J. A. BERTELLI
F. M. PERUCHI
J. R. ROST
C. P. TACCA

From the Hospital Governador Celso Ramos, Department of Orthopedics, Hand Surgery Unit, Florianópolis, SC, Brazil

Correspondence: Dr Jayme Augusto Bertelli MD, PhD, Praça Getulio Vargas, 322, Florianó polis, SC, 88020030, Brazil. Tel./fax: +55 48 2224028. E-mail:bertelli{at}matrix.com.br

Ten patients with scaphoid non-unions which had been present for longer than 2 years were treated using a vascularised bone graft harvested from the thumb and pedicled on the first dorsal metacarpal artery. Bone harvesting and grafting were performed by a single palmar approach. Concomitant cancellous bone graft was not used. Bone healing was confirmed by CT scans in nine of the ten patients. Persistence of the non-union was observed in one patient who was the oldest in this series, had the longest standing non-union and was a heavy smoker. Twelve months after surgery, nine of the ten patients had significant pain relief with an improved range of motion and grip strength.

Key Words: vascularised bone grafts • scaphoid non-union • wrist instabilities • scaphoid fracture • scaphoid pseudoarthrosis • thumb metacarpal

Journal of Hand Surgery (European Volume), Vol. 32, No. 2, 217-223 (2007)
DOI: 10.1016/J.JHSB.2006.10.014
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