Use of pronator quadratus pedicle vascularized bone graft with headless compression screw in nonunion scaphoid fractures
Adeel Ahmed Siddiqui, Maratib Ali, Ghulam Mustafa Kaimkhani, Mariyam Adeel, Muhammad Jamil, Uzair Yaqoob.
Abstract
Objective: To evaluate the effectiveness of the vascularized muscle pedicle bone graft technique for achieving healing in nonunion scaphoid fracture cases.
Methodology: This prospective study was conducted from 2017 to 2019 and inckuded 25 patients with scaphoid fractures with nonunion evaluated radiological. The procedure was done under general anesthesia in which a pedicle vascularize pronator quadrats vascularized graft taken from the radius was placed at the site of nonunion and fixed with a headless compression screw with a guide wire. Patients were assessed both clinically and radiologically every four weeks for 25 weeks
Results: Out of 25 patients, 19 (76%) were males and 6 (24%) were females. Eight (32%) had fracture of the proximal pole of the scaphoid whereas 17 (68%) had fracture of the waist of the scaphoid. The mean duration of the bony union was 12.4±2.3 weeks. The mean grip strength increased by 28% after the union, while the mean preoperative VAS score (which was 45.3±5.2 initially) decreased to a mean of 20.3±7.9 after the bony union.
Conclusion: The use of a headless screw along with a vascularized pedicle pronator quadratus graft provided high chances of the union in scaphoid fractures.
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