Journal
HAND CLINICS
Volume 40, Issue 1, Pages 117-127Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.hcl.2023.08.004
Keywords
Scaphoid nonunion; Vascularized bone graft/Flap; Local vascularized bone flaps
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If left untreated, scaphoid nonunions can lead to advanced collapse and may require salvage procedures. Different techniques, including vascularized bone flaps, have been used to address this condition, with faster union time compared to nonvascularized grafts. Vascularized bone flaps should be considered by hand surgeons to achieve high union rates.
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.
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