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Vascularized bone grafts for the treatment of carpal bone pathology

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Abstract

Primary bone healing fails to occur in 5–15 % of scaphoid bones that undergo fracture fixation. Untreated, occult fractures result in nonunion up to 12 % of the time. Conventional bone grafting is the accepted management in the treatment algorithm of scaphoid nonunion if the proximal pole is vascularized. Osteonecrosis of the proximal scaphoid pole intuitively suggests a need for transfer of the vascularized bone to the nonunion site. Scaphoid nonunion treatment aims to prevent biological and mechanical subsidence of the involved bone, destabilization of the carpus, and early degenerative changes associated with scaphoid nonunion advanced collapse. Pedicled distal radius and free vascularized bone grafts (VBGs) offer hand surgeons an alternative treatment option in the management of carpal bone nonunion. VBGs are also indicated in the treatment of avascular necrosis of the scaphoid (Preiser’s disease), lunate (Kienböck’s disease), and capitate. Relative contraindications to pedicled dorsal radius vascularized bone grafting include humpback deformity, carpal instability, or collapse. The free medial femoral condyle bone graft has offered a novel treatment option for the humpback deformity to restore geometry of the carpus, otherwise not provided by pedicled grafts. In general, VBGs are contraindicated in the setting of a carpal bone without an intact cartilaginous shell, in advanced carpal collapse with degenerative changes, and in attempts to salvage small or collapsed bone fragments. Wrist salvage procedures are generally accepted as the more definitive treatment option under such circumstances. This manuscript offers a current review of the techniques and outcomes of VBGs to the carpal bones.

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References

  1. Almquist E. Capitate shortening in the treatment of Kienbock’s disease. Hand Clin. 1993;9:505–12.

    PubMed  CAS  Google Scholar 

  2. Aspenberg P, Wang J, Jonsson K, et al. Experimental osteonecrosis of the lunate. Revascularization may cause collapse. J Hand Surg Br. 1994;19B:565–9.

    Google Scholar 

  3. Bain G, Durrant A. An articular-based approach to Kienbock avascular necrosis of the lunate. Tech Hand Up Extrem Surg. 2011;15(1):41–7.

    Article  PubMed  Google Scholar 

  4. Bain G, Smith M, Watts A. Arthoscopic core decompression of the lunate in early stage Kienbock disease of the lunate. Tech Hand Up Extrem Surg. 2011;15(1):66–9.

    Article  PubMed  Google Scholar 

  5. Bengoechea-Beeby M, Cepeda-Una J, Avascal-Zuloaga A. Vascularized bone graft from the index metacarpal for Kienbock’s disease: a case report. J Hand Surg Am. 2001;26A:437–43.

    Article  Google Scholar 

  6. Bertelli J, Tacca C, Rost J. Thumb metacarpal vascularized bone graft in long-standing scaphoid nonunion—a useful graft via dorsal or palmar approach: a cohort study of 24 patients. J Hand Surg Am. 2004;29A:1089–97.

    Article  Google Scholar 

  7. Boyer M, von Schroeder H, Axelrod T. Scaphoid nonunion with avascular necrosis of the proximal pole: treatment with a vascularized bone graft from the dorsum of the distal radius. J Hand Surg Br. 1998;23B:686–90.

    Google Scholar 

  8. Braun RM. Proximal pedicle bone grafting in the forearm and proximal carpal row. Orthop Trans. 1983;7:35.

    Google Scholar 

  9. Braun R. Viable pedicle bone grafting in the wrist. In: Urbaniak JR, editor. Microsurgery for major limb reconstruction. Mosby: St. Louis; 1987. p. 220–9.

    Google Scholar 

  10. Calfee R, Van Steyn M, Gyuricza C, et al. Joint leveling for advanced Kienbock’s disease. J Hand Surg Am. 2010;35A:1947–54.

    Article  Google Scholar 

  11. Chang M, Bishop A, Moran S, et al. The outcomes and complications of 1,2-intercompartmental supraretinacular artery pedicled vascularized bone grafting of scaphoid nonunions. J Hand Surg Am. 2006;31:387–96.

    Article  PubMed  Google Scholar 

  12. Coe M, Trumble T. Biomechanical comparison of methods used to treat Kienbock’s disease. Hand Clin. 1993;9:417–29.

    PubMed  CAS  Google Scholar 

  13. Daecke W, Lorenz S, Wieloch P, et al. Lunate resection and vascularized os pisiform transfer in Kienbock disease: an average of 10 years of follow-up study after Saffar’s procedure. J Hand Surg Am. 2005;30A:677–84.

    Article  Google Scholar 

  14. Daecke W, Lorenz S, Wieloch P, et al. Vascularized os pisiform for reinforcement of the lunate in Kienböck’s disease: an average of 12 years of follow-up study. J Hand Surg Am. 2005;30A:915–22.

    Article  Google Scholar 

  15. Dailiana Z, Malizos K, Zachos V, et al. Vascularized bone grafts from the palmar radius for the treatment of waist nonunions of the scaphoid. J Hand Surg Am. 2006;31:397–404.

    Article  PubMed  Google Scholar 

  16. De Smet L. Avascular nontraumatic necrosis of the scaphoid. Preiser’s disease? Chir Main. 2000;19:82–5.

    Article  PubMed  Google Scholar 

  17. Delaere O, Dury M, Molderez A, et al. Conservative versus operative treatment for Kienbock’s disease: a retrospective study. J Hand Surg Br. 1998;23B:33–6.

    Google Scholar 

  18. Dias J, Lunn P. Ten questions on kienbock’s disease of the lunate. J Hand Surg Eur. 2010;35B:538–43.

    Google Scholar 

  19. Doi K, Oda T, Soo-Heong T, et al. Free vascularized bone graft for nonunion of the scaphoid. J Hand Surg Am. 2000;25A:507–19.

    Article  Google Scholar 

  20. Elhassan B, Shin A. Vascularized bone grafting for treatment of Kienbock’s disease. J Hand Surg Am. 2009;34A:146–54.

    Article  Google Scholar 

  21. Ferlic D, Morin P. Idiopathic avascular necrosis of the scaphoid: Preiser’s disease? J Hand Surg Am. 1989;14A:13–6.

    Article  Google Scholar 

  22. Gabl M, Lutz M, Reinhart C, et al. Stage 3 Kienbock’s: reconstruction of the fractured lunate using a free vascularized iliac bone graft and external fixation. J Hand Surg Br. 2002;27B:369–73.

    Google Scholar 

  23. Gabl M, Reinhart C, Lutz M, et al. Vascularized bone graft from the iliac crest for the treatment of nonunion of the proximal part of the scaphoid with an avascular segment. J Bone Joint Surg Am. 1999;81:1414–28.

    PubMed  CAS  Google Scholar 

  24. Garcia-Elias M, Vall A, Salo J, et al. Carpal alignment after different surgical approaches to the scaphoid: a comparative study. J Hand Surg Am. 1988;13A:604–12.

    Article  Google Scholar 

  25. Gay A, Parratte S, Glard Y, et al. Isolated capitate shortening osteotomy for the early stage of Kienbock disease with neutral ulnar variance. Plast Reconstr Surg. 2009;124:560–6.

    Article  PubMed  CAS  Google Scholar 

  26. Gelberman R, Bauman T, Menon J, et al. The vascularity of the lunate bone and Kienbock’s disease. J Hand Surg Am. 1980;5A:272–8.

    Google Scholar 

  27. Goldfarb C, Hsu J, Gelberman R, et al. The Lichtman classification for Kienbock’s disease: an assessment of reliability. J Hand Surg Am. 2003;28A:74–80.

    Article  Google Scholar 

  28. Green D. The effect of avascular necrosis on Russe bone grafting for scaphoid nonunion. J Hand Surg Am. 1985;10A:597–605.

    Google Scholar 

  29. Guimberteau J, Panconi B. Recalcitrant non-union of the scaphoid treated with a vascularized bone graft based on the ulnar artery. J Bone Joint Surg Am. 1990;72A:88–97.

    Google Scholar 

  30. Hankins C, Budoff J. Analysis of wrist motion following vascularized bone graft to the proximal scaphoid. J Hand Surg Am. 2011;36A:583–6.

    Article  Google Scholar 

  31. Hattori Y, Doi K, Sakamoto S, et al. Vascularized pedicled bone graft for avascular necrosis of the capitate: case report. J Hand Surg Am. 2009;34A:1303–7.

    Article  Google Scholar 

  32. Hayashi O, Sawaizumi T, Nambu A, et al. Closing radial wedge osteotomy for Preiser’s disease: a case report. J Hand Surg Am. 2006;31A:1154–6.

    Article  Google Scholar 

  33. Herbert T, Lanzetta M. Idiopathic osteonecrosis of the scaphoid. J Hand Surg Br. 1994;19B:174–82.

    Google Scholar 

  34. Hermans S, Degreef I, De Smet L. Vascularised bone graft for Kienbock’s disease: preliminary results. Scand J Plast Reconstr Surg Hand Surg. 2007;41:77–81.

    Article  PubMed  Google Scholar 

  35. Hori Y, Tamai S. Blood vessel transplantation to bone. J Hand Surg Am. 1979;4A:23–33.

    Google Scholar 

  36. Illarramendi A, De Carli P. Radius decompression for treatment of Kienbock disease. Tech Hand Up Extrem Surg. 2003;7(3):110–3.

    Article  PubMed  Google Scholar 

  37. Innes L, Strauch R. Systematic review of the treatment of Kienbock’s disease in its early and late stages. J Hand Surg Am. 2010;35A:713–7.

    Article  Google Scholar 

  38. Jones D, Burger H, Bishop A, et al. Treatment of scaphoid waist nonunions with an avascular proximal pole and carpal collapse: a comparison of two vascularized bone grafts. J Bone Joint Surg Am. 2008;90:2616–25.

    Article  PubMed  Google Scholar 

  39. Jones D, Moran S, Bishop A, et al. Free-vascularized medial femoral condyle bone transfer in the treatment of scaphoid nonunions. Plast Reconstr Surg. 2010;125:1176–84.

    Article  PubMed  CAS  Google Scholar 

  40. Kakar S, Bishop A, Shin A. Role of vascularized bone grafts in the treatment of scaphoid nonunions associated with proximal pole avascular necrosis and carpal collapse. J Hand Surg Am. 2011;36A:722–5.

    Article  Google Scholar 

  41. Kakar S, Giuffre J, Shin A. Revascularization procedures for Kienbock disease. Tech Hand Up Extrem Surg. 2011;15(1):55–65.

    Article  PubMed  Google Scholar 

  42. Kalainov D, Cohen M, Hendrix R, et al. Preiser’s disease: identification of two patters. J Hand Surg Am. 2003;28A:767–78.

    Article  Google Scholar 

  43. Kawai H, Yamamoto K. Pronator quadratus pedicled bone graft for old scaphoid fractures. J Bone Joint Surg Br. 1988;70B:829–31.

    Google Scholar 

  44. Kawai H, Yamamoto K, Yamamoto T, et al. Excision of the lunate in Kienböck's disease. Results after long-term follow-up. J Bone Joint Surg Br. 1988;70B(2):287–92.

    Google Scholar 

  45. Kawamura K, Chung K. Treatment of scaphoid fractures and nonunions. J Hand Surg Am. 2008;33:988–97.

    Article  PubMed  Google Scholar 

  46. Kuhlmann J, Kron C, Boabighi A, et al. Vascularised pisiform bone graft. Indications, technique and long-term results. Acta Orthop Belg. 2003;69:311–6.

    PubMed  Google Scholar 

  47. Kuhlmann J, Mimoun M, Boabighi A, et al. Vascularized bone graft pedicled on the volar carpal artery for non-union of the scaphoid. J Hand Surg Br. 1987;16B:203–10.

    Google Scholar 

  48. Larson A, Bishop A, Shin A. Dorsal distal radius vascularized pedicled bone grafts for scaphoid nonunions. Tech Hand Up Extrem Surg. 2006;10:212–23.

    Article  PubMed  Google Scholar 

  49. Larson A, Bishop A, Shin A. Free medial femoral condyle bone grafting for scaphoid nonunions with humpback deformity and proximal pole avascular necrosis. Tech Hand Up Extrem Surg. 2007;11:246–58.

    Article  PubMed  Google Scholar 

  50. Lichtman D, Mack G, MacDonald R, et al. Kienbock’s disease: the role of silicone replacment arthroplasty. J Bone Joint Surg Am. 1977;59A:899–908.

    Google Scholar 

  51. Lin H, Stern P. “Salvage” procedures in the treatment of Kienbock’s disease: proximal row carpectomy and total wrist arthrodesis. Hand Clin. 1993;9:521–6.

    PubMed  CAS  Google Scholar 

  52. Lluch A, Garcia-Elias M. Etiology of Kienbock disease. Tech Hand Up Extrem Surg. 2011;15(1):33–7.

    Article  PubMed  Google Scholar 

  53. Malizos K, Dailiana Z, Kirou M, et al. Longstanding nonunions of scaphoid fractures with bone loss: successful reconstruction with vascularized bone grafts. J Hand Surg Br. 2001;26B:330–4.

    Google Scholar 

  54. Masear V, Zook E, Pichora D, et al. Strain-gauge evaluation of lunate unloading procedures. J Hand Surg Am. 1992;17A:437–43.

    Article  Google Scholar 

  55. Mathoulin C, Brunelli F. Further experience with the index metacarpal vascularized bone graft. J Hand Surg Br. 1998;23B:311–7.

    Google Scholar 

  56. Mathoulin C, Haerle M. Vascularized bone graft from the palmar carpal artery for treatment of scaphoid nonunion. J Hand Surg Br. 1998;23B:318–23.

    Google Scholar 

  57. Mathoulin C, Wahegaonkar A. Revascularization of the lunate by a volar vascularized bone graft and an osteotomy of the radius in treatment of the Kienbock’s disease. Microsurgery. 2009;29:373–8.

    Article  PubMed  Google Scholar 

  58. Menth-Chiari W, Poehling G. Preiser’s disease: arthoscopic treatment of avascular necrosis of the scaphoid. Arthroscopy. 2000;16(2):208–13.

    Article  PubMed  CAS  Google Scholar 

  59. Merrell G, Wolfe S, Slade J. Treatment of scaphoid nonunions: quantitative meta-analysis of the literature. J Hand Surg Am. 2002;27A:685–91.

    Article  Google Scholar 

  60. Moran S, Cooney W, Berger R, et al. The use of the 4 + 5 extensor compartmental vascularized bone graft for the treatment of Kienböck’s disease. J Hand Surg Am. 2005;30A:50–8.

    Article  Google Scholar 

  61. Moran S, Cooney W, Shin A. The use of vascularized grafts from the distal radius for the treatment of Preiser’s disease. J Hand Surg Am. 2006;31A:705–10.

    Article  Google Scholar 

  62. Muramatsu K, Bishop A. Cell repopulation in vascularized bone grafts. J Orthop Res. 2002;20:772–8.

    Google Scholar 

  63. Nakamura R, Horii E, Watanabe K, et al. Proximal row carpectomy versus limited wrist arthrodesis for advanced Kienböck’s disease. J Hand Surg Br. 1998;23B:741–5.

    Google Scholar 

  64. Nakamura R, Nakao E, Nishizuka T, et al. Radial osteotomy for Kienbock’s disease. Tech Hand Up Extrem Surg. 2011;15(1):48–54.

    Article  PubMed  Google Scholar 

  65. Nakamura R, Tsuge S, Watanabe K, et al. Radial wedge osteotomy for Kienbock disease. J Bone Joint Surg Am. 1991;73A(9):1391–6.

    Google Scholar 

  66. Payatakes A, Sotereanos DG. Pedicled vascularized bone grafts for scaphoid and lunate reconstruction. J Am Acad of Orthop Surg. 2009;17:744–55.

    Google Scholar 

  67. Quenzer D, Dobyns J, Linscheid R, et al. Radial recession osteotomy for Kienbock’s disease. J Hand Surg Am. 1997;22A:386–95.

    Article  Google Scholar 

  68. Rizzo M, Moran S. Vascularized bone grafts and their applications in the treatment of carpal pathology. Semin Plast Surg. 2008;22(3):213–27.

    Article  PubMed  Google Scholar 

  69. Roy-Camille R. Fractures et pseudoarthroses du scapphoide moyen: utilisation d’un greffo pedicule. Actualites de Chirurgie Orthopedique. 1965;4:197–214.

    Google Scholar 

  70. Saffar P. Replacement of the semilunar bone by the pisiform. Description of a new technique for the treatment of Kienboeck's disease. Ann Chir Main. 1982;1:276–9.

    Article  PubMed  CAS  Google Scholar 

  71. Sakai A, Toba N, Oshige T, et al. Kienböck disease treated by excisional arthroplasty with a palmaris longus tendon ball: a comparative study of cases with or without bone core. Hand Surg. 2004;9(2):145–9.

    Article  PubMed  CAS  Google Scholar 

  72. Sakai K, Kazuteru D, Kawai S. Free vascularized thin corticoperiosteal graft. Plast Reconstr Surg. 1991;87(2):290–8.

    Article  PubMed  CAS  Google Scholar 

  73. Salmon J, Stanley J, Trail I. Kienbock’s disease: conservative management versus radial shortening. J Bone Joint Surg Br. 2000;82B:820–3.

    Article  Google Scholar 

  74. Saunders B, Lichtman D. A classification-based treatment algorithm for Kienbock’s disease: current and future considerations. Tech Hand Up Extrem Surg. 2011;15:38–40.

    Article  PubMed  Google Scholar 

  75. Schuind F, Eslami S, Ledoux P. Kienbock’s disease. J Bone Joint Surg Br. 2008;90B:133–9.

    Google Scholar 

  76. Schuind F, Haentjens P, Van Innis F, et al. Prognostic factors in the treatment of carpal scaphoid nonunion. J Hand Surg Am. 1999;24A:761–76.

    Article  Google Scholar 

  77. Sheetz K, Bishop A, Berger R. The arterial blood supply of the distal radius and ulna and its potential use in vascularized pedicled bone grafts. J Hand Surg Am. 1995;20:902–14.

    Article  PubMed  CAS  Google Scholar 

  78. Simmons S, Tobias B, Lichtman D. Lunate revascularization with artery implantation and bone grafting. J Hand Surg Am. 2009;34A:155–60.

    Article  Google Scholar 

  79. Sotereanos D, Darlis N, Dailiana Z, et al. A capsular-based vascularized distal radius graft for proximal pole scaphoid pseudarthrosis. J Hand Surg Am. 2006;31A:580–7.

    Article  Google Scholar 

  80. Stahl F. On lunatomalacia (Kienbock’s disease): clinical and roentgenological study, especially on its pathogenesis and late results of immobilization treatment. Acta Chir Scand. 1947;126:1–133.

    Google Scholar 

  81. Steinmann S, Bishop A, Berger R. Use of the 1,2 intercompartmental supraretinacular artery as a vascularized pedicle bone graft for difficult scaphoid nonunion. J Hand Surg Am. 2002;27A:391–401.

    Article  Google Scholar 

  82. Straw R, Davis T, Dias J. Scaphoid nonunion: treatment with a pedicled vascularized bone graft based on the 1,2-intercomparmental supraretinacular branch of the radial artery. J Hand Surgery Br. 2002;27B:413–6.

    Article  Google Scholar 

  83. Sunagawa T, Bishop AT, Muramatsu K. Role of conventional and vascularized bone grafts in scaphoid nonunion with avascular necrosis: a canine experimental study. J Hand Surg Am. 2000;25:849–59.

    Article  PubMed  CAS  Google Scholar 

  84. Takahara M, Watanabe T, Tsuchida H, et al. Long-term follow-up of radial shortening osteotomy for Kinebock disease. Surgical technique. J Bone Joint Surg Am. 2009;91(Suppl 2):184–90.

    Google Scholar 

  85. Tamai S. Bone revascularization by vessel implantation for the treatment of Kienbock’s disease. Tech Hand Up Extrem Surg. 1999;3(3):154–61.

    Article  PubMed  CAS  Google Scholar 

  86. Tambe A, Ali F, Trail I, et al. Is radiolunate fusion a viable option in advanced Kienbock disease? Acta Orthop Belg. 2007;73:598–603.

    PubMed  Google Scholar 

  87. Tsai T, Chao E, Tu Y, et al. Management of scaphoid nonunion with avascular necrosis using 1,2 intercompartmental supraretinacular artery bone grafts. Chang Gung Med J. 2002;25:321–8.

    PubMed  Google Scholar 

  88. Tsuge S, Nakamura R. Anatomical risk factors for Kienbock’s disease. J Hand Surg Br. 1993;18B:70–5.

    Google Scholar 

  89. Tu YK, Bishop AT, Kato T, et al. Experimental carpal reverse-flow pedicle vascularized bone grafts. Part I: the anatomical basis of vascularized pedicle bone grafts based on the canine distal radius and ulna. J Hand Surg Am. 2000;25:34–45.

    Article  PubMed  CAS  Google Scholar 

  90. Tu YK, Bishop AT, Kato T, et al. Experimental carpal reverse-flow pedicle vascularized bone grafts. Part II: bone blood flow measurement by radioactive labeled microspheres in a canine model. J Hand Surg Am. 2000;25:46–54.

    Article  PubMed  CAS  Google Scholar 

  91. Vidal M, Linscheid R, Amadio P, et al. Preiser’s disease. Ann Chir Main Memb Super. 1991;10(3):227–36.

    Article  PubMed  CAS  Google Scholar 

  92. Viola R, Kiser P, Bach A, et al. Biomechanical analysis of capitate shortening with capitate hamate fusion in the treatment of Kienbock’s disease. J Hand Surg Am. 1998;23A:395–401.

    Article  Google Scholar 

  93. Waitayawinyu T, Chin S, Luria S, et al. Capitate shortening osteotomy with vascularized bone grafting for the treatment of Kienbock’s disease in the ulnar positive wrist. J Hand Surg Am. 2008;33A:1267–73.

    Article  Google Scholar 

  94. Waitayawinyu T, McCallister W, Katolik L, et al. Outcome after vascularized bone grafting of scaphoid nonunions with avascular necrosis. J Hand Surg Am. 2009;34A:387–94.

    Article  Google Scholar 

  95. Waitayawinyu T, Robertson C, Chin S, et al. The detailed anatomy of the 1,2 intercompartmental supraretinacular artery for vascularized bone grafting of scaphoid nonunions. J Hand Surg Am. 2008;33A:168–74.

    Article  Google Scholar 

  96. Waters P, Stewart S. Surgical treatment of nonunion and avascular necrosis of the proximal part of the scaphoid in adolescents. J Bone Joint Surg Am. 2002;84A:915–20.

    Google Scholar 

  97. Weiss A, Weiland A, Moore J, et al. Radial shortening for Kienbock disease. J Bone Joint Surg Am. 1991;73A(3):384–91.

    Google Scholar 

  98. Yamamoto H, Jones DB, Moran SL, et al. The arterial anatomy of the medial femoral condyle and its clinical implications. J Hand Surg. 2010;35E:569–74.

    Google Scholar 

  99. Yasuda M, Masada K, Takeuchi E, et al. Scaphotrapeziotrapezoid arthrodesis for the treatment of man stage 3B Kienbock disease. Scand J Plast Reconstr Surg Hand Surg. 2005;39:242–6.

    Article  PubMed  Google Scholar 

  100. Zafra M, Carpintero P, Cansino D. Osteonecrosis of the trapezium treated with a vascularized distal radius bone graft. J Hand Surg Am. 2004;29A:1098–101.

    Article  Google Scholar 

  101. Zaidemberg C, Siebert J, Angrigiani C. A new vascularized bone graft for scaphoid nonunion. J Hand Surg Am. 1991;16A:474–8.

    Article  Google Scholar 

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Authors and Affiliations

  1. Institute for Plastic Surgery, Southern Illinois University School of Medicine, 747 North Rutledge 3rd Floor, P.O. Box 19653, Springfield, IL, 62794, USA

    Brian M. Derby, Reuben A. Bueno, Tim Ade & Michael W. Neumeister

  2. Department of Orthopedic Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA

    Peter M. Murray

  3. Department of Orthopedic Surgery, Mayo Clinic, 200 First Street Southwest, Rochester, MN, 55905, USA

    Alexander Y. Shin

  4. Institut de la Main, 6 Square Jouvenet, 75016, Paris, France

    Christophe L. Mathoulin

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Derby, B.M., Murray, P.M., Shin, A.Y. et al. Vascularized bone grafts for the treatment of carpal bone pathology. HAND 8, 27–40 (2013). https://doi.org/10.1007/s11552-012-9479-0

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