Purpose
Although 1,2-intercompartmental supraretinacular artery (1,2-ICSRA)–based vascularized
bone grafting (VBG) has gained popularity in the treatment of scaphoid nonunion, correcting
humpback deformities with this technique remains challenging. The purpose of this
retrospective study was to determine the possibility of correcting humpback deformities
using a 1,2-ICSRA VBG with a dorsoradial approach.
Methods
We treated 25 patients with scaphoid nonunion using a 1,2-ICSRA VBG between January
2007 and December 2017. For those with a humpback deformity, we performed vascularized
wedge grafting from the dorsoradial side, instead of inlay bone grafting from the dorsal
or volar side of the scaphoid. After excluding patients with scaphoid nonunion without
a humpback deformity and those followed up for less than 6 months, we reviewed the imaging
results and union rate in the remaining 19 patients (18 men and 1 woman). The nonunion
sites and patient distribution were as follows: proximal one-third, 2; waist, 16;
and distal one-third, 1.
Results
The union rate at the last follow-up performed a minimum of 6 months after the intervention
was 94.7%. The correction was adequate in 17 patients and inadequate in 2 patients.
The lateral intrascaphoid, radiolunate, and scapholunate angles were improved.
Conclusions
Humpback and dorsal intercalated segmental instability deformities can be corrected
adequately using a 1,2-ICSRA VBG with a dorsoradial approach.
Type of study/level of evidence
Therapeutic IV.
Key words
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Article info
Publication history
Published online: July 23, 2019
Accepted:
June 5,
2019
Received:
May 22,
2019
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2020 by the American Society for Surgery of the Hand. All rights reserved.
