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Scaphoid Nonunion: Surgical Fixation with Vascularized Bone Graft–Free Medial Femoral Condyle Graft

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Abstract

There are many challenges in the successful operative treatment of scaphoid nonunions with foreshortening (“humpback” deformity), carpal collapse, and avascular necrosis (AVN). Scaphoid collapse can be effectively managed with a volar, interposition, structural bone graft. Restoration of scaphoid length also aids in reestablishing carpal height and correcting static carpal instability, such as dorsal intercalated segmental instability (DISI). In the setting of AVN, vascularized bone grafting (VBG) serves to transplant viable osteocytes with delivery of a robust supply of blood. The vascularized free medial femoral condyle (MFC) corticocancellous VBG is a valid surgical option for the treatment of these complicated scaphoid nonunions.

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Authors and Affiliations

  1. F. Edward Hebert School of Medicine, USUHS, Bethesda, MD, USA

    Peter C. Rhee

  2. Department of Orthopedic Surgery and Rehabilitation, San Antonio Military Medical Center, Fort Sam Houston, San Antonio, TX, USA

    Peter C. Rhee

  3. Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA

    Alexander Y. Shin

Authors
  1. Peter C. Rhee
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  2. Alexander Y. Shin
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Correspondence to Peter C. Rhee .

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Editors and Affiliations

  1. Robert A. Chase Hand and Upper Limb Center, Stanford University Medical Center, Palo Alto, CA, USA

    Jeffrey Yao MD (Associate Professor of Orthopedic Surgery) (Associate Professor of Orthopedic Surgery)

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Rhee, P.C., Shin, A.Y. (2015). Scaphoid Nonunion: Surgical Fixation with Vascularized Bone Graft–Free Medial Femoral Condyle Graft. In: Yao, J. (eds) Scaphoid Fractures and Nonunions. Springer, Cham. https://doi.org/10.1007/978-3-319-18977-2_16

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  • DOI: https://doi.org/10.1007/978-3-319-18977-2_16

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-18976-5

  • Online ISBN: 978-3-319-18977-2

  • eBook Packages: MedicineMedicine (R0)

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