Vascularized Bone Grafting in Treatment of Scaphoid Proximal Pole Avascular Necrosis: Two Cases Report at Military Hospital 175
摘要
Scaphoid fractures are one the most common fractures of the hand, approximately 90% of carpal bone fractures, many of which present with vague symptoms that can be misdiagnosed. With the goal of achieving bone healing, re-establishing the shape of the scaphoid, making the patient pain-free, and recovering wrist range of motion, various methods of treatment using vascularized and nonvascularized bone grafts (NVBGs) have been presented, including pedicled vascularized bone grafts (VBGs) from the dorsal side of the distal radius, that has shown good anatomical and functional outcomes in literature. Two cases of scaphoid proximal pole necrosis that have been treated by VBGs haversted from the dorsal side of the distal radius (Zaidemberg technique & Sotereanos technique) at Upper limb surgery department, Military Hospital 175. At follow-ups, adequate bone healing was achieved, the patient had pain-free, acceptable functionality of the wrist and hand, and could return to their previous occupation. With appropriate diagnosis and classification, VBGs harvested from the dorsal side of the distal radius performed at Military Hospital 175 have achieved favorable initial outcomes with regard to both bone union and postoperative wrist function, helping patients return to their occupational duties and daily routines, thereby laying a solid foundation for further prospective investigations.