Scaphoid Nonunions: Local Vascularized Bone Flaps

Justin C McCarty; Ryoko Hamaguchi; Kyle R Eberlin

doi:10.1016/j.hcl.2023.08.004

Scaphoid Nonunions: Local Vascularized Bone Flaps

Hand Clin. 2024 Feb;40(1):117-127. doi: 10.1016/j.hcl.2023.08.004. Epub 2023 Sep 15.

Authors

Justin C McCarty¹, Ryoko Hamaguchi¹, Kyle R Eberlin²

Affiliations

¹ Division of Plastic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
² Division of Plastic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: keberlin@mgh.harvard.edu.

PMID: 37979983
DOI: 10.1016/j.hcl.2023.08.004

Abstract

If untreated, scaphoid nonunions may progress to scaphoid nonunion advanced collapse in a substantial portion of cases and may require salvage procedures. Multiple different techniques have been described to address scaphoid nonunion. Vascularized bone flaps (VBFs) are associated with faster time to union compared with nonvascularized grafts. Because these are local pedicled flaps, they do not require microsurgical anastomoses and should be within the armamentarium of all hand surgeons. Appropriately chosen local VBFs, can achieve union rates up to 90% to 100% in appropriately selected patients.

Keywords: Local vascularized bone flaps; Scaphoid nonunion; Vascularized bone graft/Flap.

Publication types

Review

MeSH terms

Bone Transplantation / methods
Fractures, Ununited* / surgery
Humans
Scaphoid Bone* / surgery
Surgical Flaps / transplantation
Upper Extremity