Dorsal Vascularized Grafting for Scaphoid Nonunion: A Comparison of Two Surgical Techniques : Journal of Orthopaedic Trauma

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Original Article

Dorsal Vascularized Grafting for Scaphoid Nonunion

A Comparison of Two Surgical Techniques

Caporrino, Fábio A. MD, PhD; Dos Santos, João Baptista G. MD, PhD; Penteado, Fernando T. MD, MSc; de Moraes, Vinícius Y. MD; Belloti, João Carlos MD, PhD; Faloppa, Flávio MD, PhD

Author Information
Journal of Orthopaedic Trauma 28(3):p e44-e48, March 2014. | DOI: 10.1097/BOT.0b013e3182a4a91a

Abstract

Objectives: 

To compare the radiographic and functional outcomes of 2 surgical techniques for treating scaphoid nonunion.

Design: 

Randomized prospective study.

Patients/Participants: 

Researchers assessed the outcomes every 2 weeks until bone healing and at discharge.

Interventions: 

(1) Vascularized bone grafting (VBG) using the 1, 2 intercompartmental suprareticular artery and (2) a distal radius nonvascularized bone graft.

Main Outcomes/Interventions: 

Time to union (primary), union rate, and functional outcomes.

Results: 

Seventy-five patients were followed for 29 months; 2 were lost to final follow-up. Both groups had similar baseline characteristics. The VBG group reached bone union earlier by 12 days (P = 0.002), but union rates were similar (P = 0.312). There was also less ulnar deviation in the VBG group (P = 0.03). There were no other differences between either intervention groups.

Conclusions: 

Although the VBG group attained earlier union, this may not be clinically meaningful, nor justify the greater technical difficulty and use of resources associated with this intervention.

Level of Evidence: 

Therapeutic Level II. See instructions for authors for a complete description of levels of evidence.

© 2014 by Lippincott Williams & Wilkins

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