Scaphoid Non-Union Treated by Zaidemberg's Vascularized Bone Graft: About 30 Cases

• Main Authors: Mohamed Ali Sbai (Author), Mayssa El M'chirgui (Author), Riadh Maalla (Author), Adel Khorbi (Author)
• Format: Book
• Published: Open Journal of Orthopedics and Rheumatology - Peertechz Publications, 2016-12-30.
• Subjects: Case Report
• Online Access: Connect to this object online.

<p><strong>Introduction: </strong>Scaphoid fractures evolves in 10% of cases to nonunion. Untreated, it progresses to arthrosis of the wrist that may compromise the function of the hand. The recently described vascularized</p><p>bone grafts have helped to expand the armamentarium of management of scaphoid nonunion. We wanted</p><p>to verify those data by studying the results of Zaidemberg's graft made in our orthopedic department. <strong>Materials and methods:</strong> 30 scaphoid nonunion cases treated by a vascularized bone graft using</p><p>Zaidemberg's procedure were studied retrospectively. The clinical criteria studied were: range of motion,</p><p>the Mayo Wrist Score, the Quick Dash, and PWRE. The radiographs have controlled the consolidation and performed a full radiometry.</p><p><strong>Results: </strong>Our series is made up of young adults (average age 28 years), a male-dominated manual workers. The dominant side is attained in 60% of cas.57% of patients are smokers. The seniority of the nonunion was 4 years on average. Nonunion sat, according to Schernberg's classifi cation in zone 3 in 30% of cases. We had 50% in stage 2a and 30% in stage 2b according to Alnot's classifi cation. Fixation</p><p>was realized by pins followed by immobilization during 6 weeks on average. We had a consolidation in all cases. The tobacco intoxication had a deleterious effect, a delayed union was observed in smokers' patients. Our patients had a Mayo Wrist Mean score 72%, a PRWE to 11% and a Quick DASH 10%. Analysis of radiometry showed an improvement of the analyzed parameters.</p><p><strong>Conclusion: </strong>Zaidemberg's graft is a reliable vascularized bone graft; it requires a learning curve, these</p><p>results are better than inert transplants and Kuhlmann's graft, it is indicated in the old nonunion, stage 2 Alnot the "proximal pole necrosis and changing of the scaphoid shape".</p>