Results of treatment of scaphoid nonunion with microvascularized bone grafts of the 1,2 intercompartmental supraretinacular artery and osteosynthesis

Abstract Objective To analyze the results of treatment of scaphoid nonunion with questionable viability of the proximal fragment, but without significant deformity or collapse, using a vascularized bone graft of 1,2 intercompartmental supraretinacular artery (1,2 ICSRA) and subsequent osteosynthesis. Materials and methods A retrospective study was performed on 10 male patients with a radiographic diagnosis of nonunion. Functionality, pain using Visual Analog Score (VAS), grip strength, patient satisfaction and reintroduction to working life, using QuickDASH and may specific wrist scales were assessed after the treatment. The integration of the graft was checked by radiography. Results The mean follow-up was 31.4 months, and 90% of the questionnaires were satisfactory. The VAS decreased by 4.6 points and the flexor-extensor mobility gain was 5°. The total graft consolidation rate reached 40% in 5.5 months on average. Discussion Several studies have demonstrated better results using vascularized bone graft versus non-vascularized. From the description by Zaidemberg in 1991, the vascularized graft with 1,2 ICSRA artery, distal radius, has been the most widely used for the treatment of scaphoid nonunion. Conclusions Our results are comparable with the literature reviewed; thus using vascular graft of the 1,2 ICSRA and osteosynthesis with Herbert-type screw may be an alternative treatment for proximal scaphoid nonunion, without collapse or significant deformity.