Reconstruction of Scaphoid Non-union and Total Scaphoid Avascular Necrosis in a Pediatric Patient: a Case Report

Overview

Journal Hand (N Y)

Publisher Sage Publications

Specialties General Surgery
Orthopedics

Date 2015 Sep 3

PMID 26330781

Citations 2

Authors

Oded Ben-Amotz

Christine Ho

Douglas M Sammer

Affiliations

Soon will be listed here.

Abstract

Background: The medial femoral condyle vascularized bone graft has grown in popularity for treating recalcitrant fracture non-unions and has become particularly useful in treating scaphoid non-union with avascular necrosis of the proximal pole. The medial femoral condyle is an excellent source of dense, well-vascularized bone and results in minimal donor site morbidity.

Methods: We describe an unusual case of chronic scaphoid non-union and total scaphoid avascular necrosis in a skeletally immature patient. Scaphoid reconstruction was performed with a vascularized medial femoral condyle graft, with successful graft incorporation, and restoration of pain-free wrist motion.

Conclusions: Technical considerations for harvest of the medial femoral condyle bone graft in the skeletally immature patient are discussed.

Citing Articles

Use of a Free Vascularized Medial Femoral Condyle Flap for Revision Surgery in a Pediatric Patient with Congenital Pseudarthrosis of the Clavicle.

Murai A, Tada K, Nakada M, Matsuta M, Hayashi K, Tsuchiya H Case Rep Orthop. 2020; 2020:8872934.

PMID: 32685226 PMC: 7341426. DOI: 10.1155/2020/8872934.

Pediatric Scaphoid Nonunions: A Case Series, Review of the Literature, and Evidence-Based Guidelines.

Oestreich K, Jacomel T, Hassan S, Horwitz M, Lindau T J Wrist Surg. 2020; 9(1):2-12.

PMID: 32025347 PMC: 7000270. DOI: 10.1055/s-0039-3401035.

References

Eddeland A, Eiken O, Hellgren E, OHLSSON N . Fractures of the scaphoid. Scand J Plast Reconstr Surg. 1975; 9(3):234-9. DOI: 10.3109/02844317509022872. View

Sakai K, Doi K, Kawai S . Free vascularized thin corticoperiosteal graft. Plast Reconstr Surg. 1991; 87(2):290-8. DOI: 10.1097/00006534-199102000-00011. View

Jones Jr D, Burger H, Bishop A, Shin A . Treatment of scaphoid waist nonunions with an avascular proximal pole and carpal collapse. Surgical technique. J Bone Joint Surg Am. 2009; 91 Suppl 2:169-83. DOI: 10.2106/JBJS.I.00444. View

Russe O . Fracture of the carpal navicular. Diagnosis, non-operative treatment, and operative treatment. J Bone Joint Surg Am. 1960; 42-A:759-68. View

Sammer D, Bishop A, Shin A . Vascularized medial femoral condyle graft for thumb metacarpal reconstruction: case report. J Hand Surg Am. 2009; 34(4):715-8. DOI: 10.1016/j.jhsa.2008.12.016. View

Yamamoto H, Jones Jr D, Moran S, Bishop A, Shin A . The arterial anatomy of the medial femoral condyle and its clinical implications. J Hand Surg Eur Vol. 2010; 35(7):569-74. DOI: 10.1177/1753193410364484. View

Kapoor S, Pawar I, Kapoor S . Posttraumatic osteonecrosis and nonunion of distal pole of scaphoid. Indian J Orthop. 2013; 47(4):425-8. PMC: 3745701. DOI: 10.4103/0019-5413.114941. View

del Pinal F, Garcia-Bernal F, Regalado J, Ayala H, Cagigal L, Studer A . Vascularised corticoperiosteal grafts from the medial femoral condyle for difficult non-unions of the upper limb. J Hand Surg Eur Vol. 2007; 32(2):135-42. DOI: 10.1016/J.JHSB.2006.10.015. View

Martin D, De Biscop J, Schott H, Mondie J, Baudet J, Peri G . Mandibular reconstruction using a free vascularised osteocutaneous flap from the internal condyle of the femur. Br J Plast Surg. 1991; 44(6):397-402. DOI: 10.1016/0007-1226(91)90194-o. View

10.

Van Dijck C, Mattelaer B, De Degreef I, DE Smet L . Arterial anatomy of the free vascularised corticoperiosteal graft from the medial femoral condyle. Acta Orthop Belg. 2011; 77(4):502-5. View

11.

Grant I, Berger A, Ireland D . A vascularised bone graft from the medial femoral condyle for recurrent failed arthrodesis of the distal interphalangeal joint. Br J Plast Surg. 2005; 58(7):1011-3. DOI: 10.1016/j.bjps.2005.04.015. View

12.

Rao S, Sexton C, Higgins J . Medial femoral condyle flap donor-site morbidity: a radiographic assessment. Plast Reconstr Surg. 2013; 131(3):357e-362e. DOI: 10.1097/PRS.0b013e31827c6f38. View

13.

Espinosa G, Michael A, Wilbur A, McKusick M, Kennard D, Otto R . Osteonecrosis of the distal pole of the carpal navicular following fracture. Mil Med. 1986; 151(12):663-5. View

14.

Kaminski A, Burger H, Muller E . Free vascularised corticoperiosteal bone flaps in the treatment of non-union of long bones: an ignored opportunity?. Acta Orthop Belg. 2008; 74(2):235-9. View

15.

Larson A, Bishop A, Shin A . Free medial femoral condyle bone grafting for scaphoid nonunions with humpback deformity and proximal pole avascular necrosis. Tech Hand Up Extrem Surg. 2007; 11(4):246-58. DOI: 10.1097/bth.0b013e3180cab17c. View

16.

Szabo R, Manske D . Displaced fractures of the scaphoid. Clin Orthop Relat Res. 1988; (230):30-8. View

17.

Jones Jr D, Moran S, Bishop A, Shin A . Free-vascularized medial femoral condyle bone transfer in the treatment of scaphoid nonunions. Plast Reconstr Surg. 2010; 125(4):1176-1184. DOI: 10.1097/PRS.0b013e3181d1808c. View

18.

Jones Jr D, Burger H, Bishop A, Shin A . Treatment of scaphoid waist nonunions with an avascular proximal pole and carpal collapse. A comparison of two vascularized bone grafts. J Bone Joint Surg Am. 2008; 90(12):2616-25. DOI: 10.2106/JBJS.G.01503. View

19.

Dias J, Brenkel I, Finlay D . Patterns of union in fractures of the waist of the scaphoid. J Bone Joint Surg Br. 1989; 71(2):307-10. DOI: 10.1302/0301-620X.71B2.2925752. View

20.

Choudry U, Bakri K, Moran S, Karacor Z, Shin A . The vascularized medial femoral condyle periosteal bone flap for the treatment of recalcitrant bony nonunions. Ann Plast Surg. 2008; 60(2):174-80. DOI: 10.1097/SAP.0b013e318056d6b5. View