Vascularized bone grafting for the treatment of scaphoid non-union: case report

Abstract

Introduction. Scaphoid non-union associated with avascular proximal pole necrosis represent a really challenging problem for orthopedic surgeons and its treatment is still in debate. Case presentation. We present the case of a 33-year-old patient, with scaphoid non-union, who was treated according to Zeidenberg’s technique using a vascularized radial bone graft. The primary objectives of treatment were to obtain union of the scaphoid, to improve the functional recovery of the wrist and to allow professional reimplantation of the patient. We were able to obtain a functional graft and after 9 months the results were very good. Conclusions. Vascularized bone grafts represent the optimal method of treatment of scaphoid non-union associated to avascular proximal pole. It is mandatory to be associated to rigid osteosynthesis such as Herbert compression screw. The technique of Zeidenberg offers good results in these cases, but it should not be performed without magnifying lens and tourniquet uses.

Keywords

• scaphoid non-union
• conventional grafts
• vascularized bone graft
• Zeidenberg’s technique