Avascular necrosis with non-union of the scaphoid managed with a dorsal pedicled vascularised bone graft of the distal radius: a case report

Authors

  • Surya Rao Rao Venkata Mahipathy Department of Plastic and Reconstructive Surgery, Saveetha Medical College and Hospital, Thandalam, Tamil Nadu, India http://orcid.org/0000-0002-8214-8871
  • Alagar Raja Durairaj Department of Plastic and Reconstructive Surgery, Saveetha Medical College and Hospital, Thandalam, Tamil Nadu, India
  • Narayanamurthy Sundaramurthy Department of Plastic and Reconstructive Surgery, Saveetha Medical College and Hospital, Thandalam, Tamil Nadu, India
  • Anand P. Jayachandiran Department of Plastic and Reconstructive Surgery, Saveetha Medical College and Hospital, Thandalam, Tamil Nadu, India
  • Suresh Rajendran Department of Plastic and Reconstructive Surgery, Saveetha Medical College and Hospital, Thandalam, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2349-2902.isj20214022

Keywords:

Avascular necrosis, Non-union, Scaphoid, Vascularised bone graft

Abstract

Avascular necrosis (AVN) of the scaphoid is common following proximal pole fractures due to an arduous retrograde arterial vascular supply and it is a challenge to the hand surgeon. The treatment for scaphoid non-union with avascular necrosis is vascularized or non-vascularized bone grafts. Non vascularised bone grafts (NVBGs) can be categorized as autograft or allograft and cancellous or cortical bone grafts. Vascularised bone grafts promote biological healing and revascularizes ischaemic bone and they are free or pedicled grafts. Pedicled vascularised bone grafts maintain the vascular supply of the donor bone graft and this leads to better bone remodelling, less osteopenia, faster incorporation and better maintenance of bone mass compared to the non-vascularised graft with good clinical and radiological outcomes. In this paper, we have treated avascular necrosis of scaphoid with a pedicled vascularised bone graft based on the 1, 2 intercompartmental supraretinacular artery (1, 2-ICSRA) that resulted in a favourable outcome.

Author Biographies

Surya Rao Rao Venkata Mahipathy, Department of Plastic and Reconstructive Surgery, Saveetha Medical College and Hospital, Thandalam, Tamil Nadu, India

Professor & Head,
Dept. of Plastic & Reconstructive Surgery

Alagar Raja Durairaj, Department of Plastic and Reconstructive Surgery, Saveetha Medical College and Hospital, Thandalam, Tamil Nadu, India

Professor,
Dept. of Plastic & Reconstructive Surgery

Narayanamurthy Sundaramurthy, Department of Plastic and Reconstructive Surgery, Saveetha Medical College and Hospital, Thandalam, Tamil Nadu, India

Associate Professor,
Dept. of Plastic & Reconstructive Surgery

Anand P. Jayachandiran, Department of Plastic and Reconstructive Surgery, Saveetha Medical College and Hospital, Thandalam, Tamil Nadu, India

Assistant Professor,
Dept. of Plastic & Reconstructive Surgery

Suresh Rajendran, Department of Plastic and Reconstructive Surgery, Saveetha Medical College and Hospital, Thandalam, Tamil Nadu, India

Senior Resident,
Dept. of Plastic & Reconstructive Surgery

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Published

2021-09-28

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Section

Case Reports