MR angiogram confirms sustained blood flow in 1,2 ICSR artery of vascularized bone grafting in scaphoid nonunion treatment

Eur J Orthop Surg Traumatol. 2019 Feb;29(2):343-348. doi: 10.1007/s00590-018-2339-z. Epub 2018 Nov 15.

Abstract

Purpose: To evaluate the functioning of 1,2 intercompartmental supraretinacular artery (ICSRA) in vascularized bone grafting (VBG) of scaphoid nonunions with avascular necrosis of proximal pole.

Materials and methods: Fourteen patients with scaphoid nonunion were treated operatively with 1,2 ICSRA VBG. Viability of the pedicle artery was evaluated by MR angiography with intravenous contrast agent.

Results: In 13 out of 14 patients, the 1,2 ICSR artery was found to be patent and functional. Revascularization of scaphoid proximal pole was revealed in all cases, and nonunion healing was confirmed as well.

Conclusion: 1,2 ICSRA VBG in scaphoid nonunion is an effective surgical technique. It combines the advantages of bone grafting and vascular supply via the transferred pedicle artery which seems to be functional postoperatively if a meticulous operative technique is used.

Keywords: 1,2 Intercompartmental supraretinacular artery; MR angiography; Scaphoid nonunion; Vascularized bone grafting.

MeSH terms

  • Adult
  • Arteries / diagnostic imaging
  • Autografts / blood supply*
  • Autografts / diagnostic imaging
  • Contrast Media
  • Female
  • Follow-Up Studies
  • Fracture Healing
  • Fractures, Bone / surgery*
  • Fractures, Ununited / surgery*
  • Humans
  • Magnetic Resonance Angiography*
  • Male
  • Scaphoid Bone / blood supply
  • Scaphoid Bone / injuries*
  • Surgical Flaps / blood supply
  • Young Adult

Substances

  • Contrast Media