Dorsal Vascularized Grafting for Scaphoid Nonunion: A Comparison of Two Surgical Techniques

Objectives:To compare the radiographic and functional outcomes of 2 surgical techniques for treating scaphoid nonunion.Design:Randomized prospective study.Patients/Participants:Researchers assessed the outcomes every 2 weeks until bone healing and at discharge.Interventions:(1) Vascularized bone grafting (VBG) using the 1, 2 intercompartmental suprareticular artery and (2) a distal radius nonvascularized bone graft.Main Outcomes/Interventions:Time to union (primary), union rate, and functional outcomes.Results:Seventy-five patients were followed for 29 months; 2 were lost to final follow-up. Both groups had similar baseline characteristics. the VBG group reached bone union earlier by 12 days (P = 0.002), but union rates were similar (P = 0.312). There was also less ulnar deviation in the VBG group (P = 0.03). There were no other differences between either intervention groups.Conclusions:Although the VBG group attained earlier union, this may not be clinically meaningful, nor justify the greater technical difficulty and use of resources associated with this intervention.Level of Evidence:Therapeutic Level II. See instructions for authors for a complete description of levels of evidence.Universidade Federal de São Paulo, Disciplina Cirurgia Mao & Membro Super, Escola Paulista Med, São Paulo, BrazilUniversidade Federal de São Paulo, Disciplina Cirurgia Mao & Membro Super, Escola Paulista Med, São Paulo, BrazilWeb of Scienc