• Handchir Mikrochir Plast Chir · May 1999

    [Proximal scaphoid pseudarthrosis with avascular pol fragment: long-term outcome after reconstruction with microvascular pedicled iliac crest bone graft].

    • M Gabl, C Reinhart, S Pechlaner, and H Hussl.
    • Universitätsklinik für Unfallchirurgie, Innsbruck.
    • Handchir Mikrochir Plast Chir. 1999 May 1; 31 (3): 196-9.

    Abstract56 patients suffering from scaphoid nonunion with avascular necrosis of the proximal pole were treated by a free vascularized iliac bone graft. Follow-up examination of 27 patients at 8.8 years included evaluation of scaphoid nonunion, progression of arthrosis and clinical parameters. Union was achieved in 85% of the patients (Group A). Arthrosis remained unchanged in 75%. No carpal collapse occurred. 81% of the patients were painfree. Grip strength was 95% and range of motion 75% compared to the noninvolved wrist. Nonunion persisted in 15% (Group B). In all these patients carpal collapse had established. 66% of the patients showed mild pain. Grip strength was 71% and range of motion 65% of normal. Transplantation of a free vascularized iliac bone graft resulted in union of a scaphoid pseudarthrosis with avascular proximal pole in 85%. When union occurred, progression of degenerative arthrosis could be arrested and good clinical late results could be achieved.

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