Comparison of the functional and radiological outcomes ofvascularized and non-vascularized bone graft options in thetreatment of scaphoid nonunion

Abstract

Objectives: This study aims to compare the functional andradiological outcomes of the patients with scaphoid waist nonuniontreated with non-vascularized bone graft and vascularized bonegraft options. Patients and methods: Between January 2016 and February 2020,a total of 24 patients (22 males, 2 females; mean age: 30.6±9.4years; range, 18 to 66 years) with scaphoid waist nonunion whowere treated with vascularized or non-vascularized bone graftwere retrospectively analyzed. Of these patients, eight weretreated with iliac crest non-vascularized bone graft (IC-NBG),seven with vascularized free medial femoral condyle (MFC)graft, and nine with 1,2-intercompartmental supraretinacularartery pedicled vascularized bone graft (1,2-ICSRA-VBG). Thegrip strength, flexion, extension, radial deviation, ulnar deviationangles were measured and compared to the contralateral hand forfunctional outcomes. Union rates, the scaphoid height-to-lengthratio, the lateral intrascaphoid angle (LISA) were evaluated forradiological outcomes. The Mayo Wrist Score, Visual AnalogScale (VAS) score, and Quick Disability of the Arm, Shoulderand Hand (Q-DASH) Questionnaire score were calculated. Results: Union was observed in seven (87.5%) patients afterIC-NBG, in six (85.7%) patients after MFC bone graft and nine(100%) patients in the treatment group with 1,2-ICSRA-VBG.There were no statistically significant differences among theIC-NBG, MFC and 1,2-ICSRA-VBG groups in terms of theunion rates, the scaphoid height-to-length ratio, VAS score,Q-DASH score, grip strength and flexion, ulnar deviation, radialdeviation angles after surgery (p>0.05). However, extensionwas statistically lower in the MFC group than IC-NBG and1,2-ICSRA-VBG groups after surgery. The Mayo score wasbetter in the IC-NBG group than MFC and 1,2-ICSRA-VBG,indicating a statistically significant difference (p