Publication:

Outcome of vascularised muscle pedicle bone graft for scaphoid non-union

Background The objective of the study was to assess the outcome of vascularised muscle pedicle bone graft for scaphoid non-union.

Methods 14 men and 6 women aged 18-45 (mean 25) years with non-union of scaphoid involving proximal pole (n=4), waist (n=14), distal pole (n=2) were randomized to undergo vascularised muscle pedicle bone graft with Herbert screw fixation. The mean duration of non-union was 10 months (range 4-14 months).

Results The mean follow up duration was 24 months. 17 of 20 achieved union. 12 of 20 achieved correction of both scapholunate and radiolunate angle. 5 of 20 did not achieve full correction of sacpholunate and radiolunate angle. 3 of 20 did not achieve union. 2 of these 3 were associated with proximal pole absorption. There was no hardware failure or any iatrogenic fracture during pedicle dissection.

Conclusions The use of vascularised bone graft has proved to be an effective method for treating scaphoid non-union, especially non-union with an avascular proximal pole and those that have failed to heal after previous procedure.