• A D Tambe, L Cutler, J Stilwell, S R Murali, I A Trail, and J K Stanley.
• Wrightington Hospital, Wrightington, Wigan & Leigh NHS Trust, UK. anant_tambe@yahoo.com
• J Hand Surg Eur Vol. 2006 Apr 1;31(2):185-90.

AbstractAchieving union using conventional grafts has a high chance of failure in patients with recalcitrant non-union (persistent pseudarthrosis) of the scaphoid bone, an avascular proximal fragment and previous failed surgeries because of poor host bed vascularity. Eleven patients with long-standing non-union were treated with vascularized pedicle bone grafting and supplementary corticocancellous grafting. Five had screw fixation and six were fixed with K-wires. The average age of the patients was 28 years, average duration of the non-union was 39 months and mean radiological follow-up was 32 months. There were no significant skeletal complications, although two patients developed neuromata. At review, only six of the 11 non-unions were united. Whilst this is a difficult clinical problem and achieving union is a formidable challenge, we believe that there is a role for such extensive surgery in order to achieve good postoperative function.

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