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Comparison between Vascular and Non-Vascular Bone Grafting in Scaphoid Nonunion: A Systematic Review

Background: Scaphoid fractures correspond to 60% of all carpal fractures, with a risk of 10% to progress towards non-union. Furthermore, ~3% present avascular necrosis (AVN) of the proximal pole, which is one of the main complications related to the peculiar vascularization of the bone. Scaphoid non...

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Autores principales: Testa, Gianluca, Lucenti, Ludovico, D’Amato, Salvatore, Sorrentino, Marco, Cosentino, Pierluigi, Vescio, Andrea, Pavone, Vito
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9225170/
https://www.ncbi.nlm.nih.gov/pubmed/35743472
http://dx.doi.org/10.3390/jcm11123402
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author Testa, Gianluca
Lucenti, Ludovico
D’Amato, Salvatore
Sorrentino, Marco
Cosentino, Pierluigi
Vescio, Andrea
Pavone, Vito
author_facet Testa, Gianluca
Lucenti, Ludovico
D’Amato, Salvatore
Sorrentino, Marco
Cosentino, Pierluigi
Vescio, Andrea
Pavone, Vito
author_sort Testa, Gianluca
collection PubMed
description Background: Scaphoid fractures correspond to 60% of all carpal fractures, with a risk of 10% to progress towards non-union. Furthermore, ~3% present avascular necrosis (AVN) of the proximal pole, which is one of the main complications related to the peculiar vascularization of the bone. Scaphoid non-union can be treated with vascularized and non-vascularized bone grafting. The aim of the study is to evaluate the rates of consolidation of scaphoid non-union treated using two types of grafts. Methods: A systematic review of two electronic medical databases was carried out by two independent authors, using the following inclusion criteria: non-union of the proximal pole of the scaphoid bone, treated with vascular bone grafting (VBG) or non-vascular bone grafting (NVBG), with or without the use of internal fixation, patients aged ≥ 10 years old, and a minimum of 12 months follow-up. Research of any level of evidence that reports clinical results and regarding non-union scaphoid, either using vascularized or non-vascularized bone grafting, has been included. Results: A total of 271 articles were identified. At the end of the first screening, 104 eligible articles were selected for the whole reading of the text. Finally, after reading the text and the control of the reference list, we selected 26 articles following the criteria described above. Conclusions: The choice of the VBG depends mainly on the defect of the scaphoid and on the surgeon’s knowledge of the different techniques. Free vascular graft with medial femoral condyle (MFC) seems to be a promising alternative to local vascularized bone grafts in difficult cases.
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spelling pubmed-92251702022-06-24 Comparison between Vascular and Non-Vascular Bone Grafting in Scaphoid Nonunion: A Systematic Review Testa, Gianluca Lucenti, Ludovico D’Amato, Salvatore Sorrentino, Marco Cosentino, Pierluigi Vescio, Andrea Pavone, Vito J Clin Med Systematic Review Background: Scaphoid fractures correspond to 60% of all carpal fractures, with a risk of 10% to progress towards non-union. Furthermore, ~3% present avascular necrosis (AVN) of the proximal pole, which is one of the main complications related to the peculiar vascularization of the bone. Scaphoid non-union can be treated with vascularized and non-vascularized bone grafting. The aim of the study is to evaluate the rates of consolidation of scaphoid non-union treated using two types of grafts. Methods: A systematic review of two electronic medical databases was carried out by two independent authors, using the following inclusion criteria: non-union of the proximal pole of the scaphoid bone, treated with vascular bone grafting (VBG) or non-vascular bone grafting (NVBG), with or without the use of internal fixation, patients aged ≥ 10 years old, and a minimum of 12 months follow-up. Research of any level of evidence that reports clinical results and regarding non-union scaphoid, either using vascularized or non-vascularized bone grafting, has been included. Results: A total of 271 articles were identified. At the end of the first screening, 104 eligible articles were selected for the whole reading of the text. Finally, after reading the text and the control of the reference list, we selected 26 articles following the criteria described above. Conclusions: The choice of the VBG depends mainly on the defect of the scaphoid and on the surgeon’s knowledge of the different techniques. Free vascular graft with medial femoral condyle (MFC) seems to be a promising alternative to local vascularized bone grafts in difficult cases. MDPI 2022-06-14 /pmc/articles/PMC9225170/ /pubmed/35743472 http://dx.doi.org/10.3390/jcm11123402 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Systematic Review
Testa, Gianluca
Lucenti, Ludovico
D’Amato, Salvatore
Sorrentino, Marco
Cosentino, Pierluigi
Vescio, Andrea
Pavone, Vito
Comparison between Vascular and Non-Vascular Bone Grafting in Scaphoid Nonunion: A Systematic Review
title Comparison between Vascular and Non-Vascular Bone Grafting in Scaphoid Nonunion: A Systematic Review
title_full Comparison between Vascular and Non-Vascular Bone Grafting in Scaphoid Nonunion: A Systematic Review
title_fullStr Comparison between Vascular and Non-Vascular Bone Grafting in Scaphoid Nonunion: A Systematic Review
title_full_unstemmed Comparison between Vascular and Non-Vascular Bone Grafting in Scaphoid Nonunion: A Systematic Review
title_short Comparison between Vascular and Non-Vascular Bone Grafting in Scaphoid Nonunion: A Systematic Review
title_sort comparison between vascular and non-vascular bone grafting in scaphoid nonunion: a systematic review
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9225170/
https://www.ncbi.nlm.nih.gov/pubmed/35743472
http://dx.doi.org/10.3390/jcm11123402
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