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Free Medial Femoral Condyle Bone Grafting for Scaphoid Nonunions With Humpback Deformity and Proximal Pole Avascular Necrosis

2007; Lippincott Williams & Wilkins; Volume: 11; Issue: 4 Linguagem: Inglês

10.1097/bth.0b013e3180cab17c

1531-6572

A. Noelle Larson, Allen T. Bishop, Alexander Y. Shin,

Surgical Sutures and Adhesives

Treatment of scaphoid nonunions remains a challenging problem, especially in the setting of proximal pole avascular necrosis or humpback deformity. Conventional bone grafting techniques have demonstrated unpredictable results in the setting of collapse deformities, whereas pedicled dorsal distal radius vascularized bone grafts have recently been reported to have nearly a 50% failure rate when used in scaphoid nonunions with proximal pole nonunion. Free vascularized medial femoral condyle bone grafting is one option for the treatment of scaphoid nonunions with proximal pole avascular necrosis associated with a humpback deformity. The indications, contraindications, and technique of free vascularized medial femoral condyle bone grafting are presented for the treatment of scaphoid nonunions associated with proximal pole avascular necrosis and humpback deformities.