Local Vascular Bone Graft Reconstruction

  • Louisa N. Banks
  • Ian A. Trail


Huntington first described vascularised bone graft in 1905 (pedicled fibular to cover a tibial defect). Since then, pedicle grafts have been reported using the rib, clavicle, iliac crest, scapula, medial femoral condyle, distal radius, greater and lesser trochanter, pisiform, humerus and second metacarpal. Vascularised bone grafts (VBGs) have been used in the treatment of many pathologies including: those involving the carpus; intercalary defects of long bones; lower limb osteomyelitis; in the spine and also for reconstruction (of the mandible) [1–4].


Vascularised bone grafts Pedicled bone grafts Kienböck’s disease Preiser’s disease Intercompartmental supraretinacular artery Extensor compartment artery Corticocancellous graft Avascular necrosis carpus Microvascular Non-union 


  1. 1.
    Bhathena HM. Mandibular reconstruction with local live vascularised bone transfer. Acta Chir Plast. 2004;46(3):76–80.PubMedGoogle Scholar
  2. 2.
    Tu YK, Yen CY. Role of vascularized bone grafts in lower extremity osteomyelitis. Orthop Clin North Am. 2007;38(1):37–49. vi.PubMedCrossRefGoogle Scholar
  3. 3.
    Capanna R, Campanacci DA, et al. A new reconstructive technique for intercalary defects of long bones: the association of massive allograft with vascularized fibular autograft. Long-term results and comparison with alternative techniques. Orthop Clin North Am. 2007;38(1):51–60. vi.PubMedCrossRefGoogle Scholar
  4. 4.
    Jones DB, Rhee PC, Shin AY. Vascularised bone grafts for scaphoid nonunions. J Hand Surg. 2012;37A:1090–4.CrossRefGoogle Scholar
  5. 5.
    Goldberg VM, Shaffer JW, Field G, Davy DT. Biology of vascularized bone grafts. Orthop Clin North Am. 1987;18(2):197–205.PubMedGoogle Scholar
  6. 6.
    Roux JL. Vascularized bone transfers in the wrist and hand. Chir Main. 2003;22(4):173–85.PubMedCrossRefGoogle Scholar
  7. 7.
    Kuhlmann JN, Mimoun M, Boabighi A, Baux S. Vascularized bone graft pedicled on the volar carpal artery for non-union of the scaphoid. J Hand Surg. 1987;12B:203–10.CrossRefGoogle Scholar
  8. 8.
    Zaidemberg C, Siebert JW, Angrigiani C. A new vascularized bone graft for scaphoid nonunion. J Hand Surg Am. 1991;16(3):474–8.PubMedCrossRefGoogle Scholar
  9. 9.
    Bürger KH, Gaggl AJ, et al. Free microvascular transfer of segmental corticocancellous femur for treatment of avascular scaphoid necrosis. Handchir Mikrochir Plast Chir. 2009;41(1):44–51.PubMedCrossRefGoogle Scholar
  10. 10.
    Kuschner SH, Lane CS, Brien WW, Gellman H. Scaphoid fractures and scaphoid non-union. Diagnosis and treatment. Orthop Rev. 1994;23(11):861–71.PubMedGoogle Scholar
  11. 11.
    Braun RN. Pronator pedicle bone grafting in the forearm and proximal row. Orthop Trans. 1983;7:35.Google Scholar
  12. 12.
    Kawai H, Yamamoto K. Pronator quadratus pedicled bone graft for old scaphoid fractures. J Bone Joint Surg Br. 1988;70(5):829–31.PubMedGoogle Scholar
  13. 13.
    Chang MA, Bishop AT, Moran SL, Shin AY. The outcomes and complications of 1,2-intercompartmental supraretinacular artery pedicled vascularized bone grafting of scaphoid nonunions. J Hand Surg Am. 2006;31(3):387–96.PubMedCrossRefGoogle Scholar
  14. 14.
    Sheetz KK, Bishop AT, Berger RA. The arterial blood supply of the distal radius and its potential use in vascularised pedicled bone grafts. J Hand Surg. 1995;20A:902–14.CrossRefGoogle Scholar
  15. 15.
    Waitayawinyu T, Robertson C, Chin SH, Schlenker JD, Pettrone S, Trumble TE. The detailed anatomy of the 1,2 intercompartmental supraretinacular artery for vascularised bone grafting of scaphoid non unions. J Hand Surg. 2008;33A:168–74.CrossRefGoogle Scholar
  16. 16.
    Kalainov DM, Cohen MS, et al. Preiser’s disease: identification of two patterns. J Hand Surg Am. 2003;28(5):767–78.PubMedCrossRefGoogle Scholar
  17. 17.
    Herbert TJ, Lanzetta M. Idiopathic avascular necrosis of the scaphoid. J Hand Surg Br. 1994;19(2):174–82.PubMedCrossRefGoogle Scholar
  18. 18.
    Judet R, Roy-Camille R, Guillamon JL. Treatment of pseudarthrosis of the carpalscaphoid by pediculated graft. Rev Chir Orthop Reparatrice Appar Mot. 1972;58(7):699–705.PubMedGoogle Scholar
  19. 19.
    Moran SL, Shin AY. Vascularized bone grafting for the treatment of carpalpathology. Orthop Clin North Am. 2007;38(1):73–85. vi.PubMedCrossRefGoogle Scholar
  20. 20.
    Aspenberg P, Wang JS, et al. Experimental osteonecrosis of the lunate. Revascularization may cause collapse. J Hand Surg Br. 1994;19(5):565–9.PubMedCrossRefGoogle Scholar
  21. 21.
    Braga-Silva J, Peruchi FM, et al. A comparison of the use of distal radius vascularised bone graft and non-vascularised iliac crest bone graft in the treatment of non-union of scaphoid fractures. J Hand Surg Eur Vol. 2008;33(5):636–40.PubMedCrossRefGoogle Scholar
  22. 22.
    Ribak S, Medina CE, et al. Treatment of scaphoid nonunion with vascularised and nonvascularised dorsal bone grafting from the distal radius. Int Orthop. 2010;34(5):683–8.PubMedCentralPubMedCrossRefGoogle Scholar
  23. 23.
    Boyer MI, von Schroeder HP, Axelrod TS. Scaphoid non-union 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;23(5):686–90.PubMedCrossRefGoogle Scholar
  24. 24.
    Malizos KN, Dailiana ZH, et al. Longstanding nonunions of scaphoid fractures with bone loss: successful reconstruction with vascularized bone grafts. J Hand Surg Br. 2001;26(4):330–4.PubMedCrossRefGoogle Scholar
  25. 25.
    Gras M, Mathoulin C. Vascularized bone graft pedicled on the volar carpal artery from the volar distal radius as primary procedure for scaphoid non-union. Orthop Traumatol Surg Res. 2011;8:800–6.CrossRefGoogle Scholar
  26. 26.
    Bertelli JA, Peruchi FM, Rost JR, Tacca CP. Treatment of scaphoid non-unions by a palmar approach with vascularised bone graft harvested from the thumb. J Hand Surg. 2007;32B:217–23.CrossRefGoogle Scholar
  27. 27.
    Merrell GA, Wolfe SW, Slade 3rd JF. Treatment of scaphoid nonunions: quantitative meta-analysis of the literature. J Hand Surg Am. 2002;27(4):685–91.PubMedCrossRefGoogle Scholar
  28. 28.
    Moran SL, Cooney WP, Shin AY. The use of vascularized grafts from the distal radius for the treatment of Preiser’s disease. J Hand Surg Am. 2006;31(5):705–10.PubMedCrossRefGoogle Scholar
  29. 29.
    Daecke W, Lorenz S, et al. Lunate resection and vascularized Os pisiform transfer in Kienböck’s Disease: an average of 10 years of follow-up study after Saffar’s procedure. J Hand Surg Am. 2005;30(4):677–84.PubMedCrossRefGoogle Scholar
  30. 30.
    Bochud RC, Büchler U. Kienböck’s disease, early stage 3–height reconstruction and core revascularization of the lunate. J Hand Surg Br. 1994;19(4):466–78.PubMedCrossRefGoogle Scholar
  31. 31.
    Tamai S, Yajima H, Ono H. Revascularization procedures in the treatment of Kienböck’s disease. Hand Clin. 1993;9(3):455–66.PubMedGoogle Scholar
  32. 32.
    Arora R, Lutz M, et al. Free vascularised iliac bone graft for Kienböck’s disease stage III. Handchir Mikrochir Plast Chir. 2010;42(3):198–203.PubMedCrossRefGoogle Scholar
  33. 33.
    Afshar A. Lunate revascularization after capitate shortening osteotomy in Kienböck’s disease. J Hand Surg Am. 2010;35(12):1943–6.PubMedCrossRefGoogle Scholar
  34. 34.
    Waitayawinyu T, Chin SH, et al. Capitate shortening osteotomy with vascularized bone grafting for the treatment of Kienböck’s disease in the ulnar positive wrist. J Hand Surg Am. 2008;33(8):1267–73.PubMedCrossRefGoogle Scholar
  35. 35.
    Rizzo M, Moran SL. Vascularized bone grafts and their applications in treatment of carpal pathology. Semin Plast Surg. 2008;22(3):213.PubMedCentralPubMedCrossRefGoogle Scholar
  36. 36.
    Yajima H, Tamai S, et al. Experimental study on secondary living bone graft–method of creating new donor by vascular bundle implantation to isolated bone. Nihon Seikeigeka Gakkai Zasshi. 1989;63(5):539–48.PubMedGoogle Scholar
  37. 37.
    Mizumoto S, Inada Y, Weiland AJ. Fabrication of vascularized bone grafts using ceramic chambers. J Reconstr Microsurg. 1993;9(6):441–9.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London 2015

Authors and Affiliations

  1. 1.Department of Trauma & OrthopaedicsGlan Clwyd HospitalNorth WalesUK
  2. 2.Department of Upper Limb SurgeryWrightington Hospital NHS Foundation TrustWiganUK

Personalised recommendations