Abstract
Vascularized bone grafts offer several distinct advantages over conventional, nonvascularized
autografts. Because cell viability and structural integrity is maintained, primary
bone healing may occur, rather than creeping substitution of necrotic bone. Cortical
osteocyte viability is significantly higher than in nonvascularized grafts, approaching
90% of normal controls. Minimal bone necrosis results in less remodeling, maintained
bone mass, and diminished osteopenia after transfer. Vascularized grafts also exhibit
superior material properties including strength, toughness, and elastic modulus 2
to 4 times greater than conventional structural grafts. Revascularization and remodeling
of adjacent avascular bone also is facilitated by living grafts. All of these properties
make them attractive for treatment of some scaphoid nonunions as well as carpal avascular
necrosis. The principles, anatomy, application, experimental, and clinical studies
of carpal vascularized pedicled bone grafts are the focus of this article. Copyright
© 2002 by the American Society for Surgery of the Hand
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References
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Article info
Publication history
1531-0914/02/0204-0005$35.00/0
Identification
Copyright
© 2002 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
