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Journal of Hand Surgery (European Volume)
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Articles

Vascularised Bone Grafting in the Management of Scaphoid Non-Union – A Review of 34 Cases

A. K. KAPOOR
N. W. THOMPSON
I. RAFIQ
M. J. HAYTON
J. STILLWELL
I. A. TRAIL

From the Centre for Hand and Upper Limb Surgery, Wrightington Hospital, Wigan, UK

Correspondence: Mr A. Kapoor, Clinical Research Fellow, Wrightington Hospital, Hall Lane, Appley Bridge, Wigan WN6 9EP, UK. Tel.: +44 1257256477; fax: +44 1257256441.E-mail: dramitkapoor{at}doctors.net.uk.

We reviewed the outcomes of 34 patients who had undergone vascularised bone grafting for a chronic scaphoid non-union. Mean age was 27 years (range 16–46 years). The dominant hand was involved in 17 cases. Eleven patients were smokers. In 18 cases the fracture involved the proximal and in 16 cases the middle third of the scaphoid. In 26 patients the proximal scaphoid fragment was deemed avascular. Sixteen patients had previously undergone scaphoid fixation and non-vascularised bone grafting. At a follow-up of 1 to 3 years (mean 1.6 years), 15 of the 34 scaphoid non-unions had united. Injury to the dominant hand and duration of the non-union significantly increased the risk of failure. Persistent non-union was more common in proximal third fractures and in the presence of an avascular proximal pole but these findings did not reach statistical significance.

Key Words: scaphoid • non-union • vascularised bone graft

Journal of Hand Surgery (European Volume), Vol. 33, No. 5, 628-631 (2008)
DOI: 10.1177/1753193408092038
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