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Anatomical comparative study of two vascularized bone grafts for the wrist

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Abstract

Atrophic scaphoid non-union and lunate necrosis can be treated with vascularized bone grafting; through a posterior approach as described by Zaidemberg, based on a supraretinacular artery, or through an anterior approach, based on the volar carpal artery, according to Kuhlmann’s procedure. The aim of our study was to determine the area covered by each of these two grafts and their respective future applications. Fifteen hands from eight adult human cadavers, free of any scar, were dissected after injection of colored fluid latex, through dorso-radial approach for Zaidemberg’s graft and through volar approach for Kuhlmann’s. We observed the morphological parameters of the pedicles and the arc of rotation of each flap. The volar vascularized graft had a constant origin and it could be transferred to the scaphoid, the lunate and the scapholunate joint. The posterior graft of Zaidemberg was technically more difficult to harvest because of the anatomical variations. It made it possible to reach the scaphoid, the trapezium and the scaphotrapeziotrapezoid joint line. Both these two vascularized bone grafts represent interesting procedures for treatment of scaphoid non-union or lunate necrosis, or intracarpal bones arthrodesis. They bring various possibilities of bone covering, related to specific area of mobilization and are not opposite procedures, but have different targeted indications. One must better define the respective places of the vascularized bone grafts, compared with the traditional free (non-vascularized) graft.

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References

  1. Alnot JY, de Cheveigné C, Bleton R (1992) Chronic, post-traumatic scaphoid–lunate instability treated by scaphoid–lunate arthrodesis. Ann Chir Main 11(2):107–118

    Article  CAS  Google Scholar 

  2. Busa R, Adani R, Castagnetti C, Zaffe D, Mingione A (1999) Neovascularized bone grafts: experimental investigation. Microsurgery 19:289–295

    Article  PubMed  CAS  Google Scholar 

  3. Green DP (1985) The effect of avascular necrosis on Russe bone grafting for scaphoid nonunion. J Hand Surg [Am] 10-A(5):597–605

    Google Scholar 

  4. Haddad FS, Goddard NJ (1998) Acute percutaneous scaphoid fixation using a cannulated screw. Ann Chir Main 17(2):119–126

    Article  CAS  Google Scholar 

  5. Haerle M, Schaller HE, Mathoulin C (2003) Vascular anatomy of the palmar surface of the distal radius and ulna: its relevance to pedicle bone grafts at the distal palmar. J Hand Surg [Br] 28-B(2):131–136

    Article  Google Scholar 

  6. Hildebrand KA, Ross DC, Patterson SD et al (2000) Dorsal perilunate dislocations and fracture-dislocations: questionnaire, clinical, and radiographic evaluation. J Hand Surg [Am] 25-A(6):1069–1079

    Google Scholar 

  7. Judet R, Roy-Camille R, Guillamon JL (1972) Treatment of pseudarthrosis of the carpal scaphoid by pediculated graft. Rev Chir Orthop 58(7):699–705

    PubMed  CAS  Google Scholar 

  8. Kuhlmann JN, Mimoun M, Boabighi A, Baux S (1987) Vascularized bone graft pedicled on the volar carpal artery for non-union of the scaphoid. J Hand Surg [Br] 12-B(2):203–210

    Article  Google Scholar 

  9. Kuschner SH, Lane CS, Brien WW, Gellmann H (1994) Scaphoid fractures and scaphoid nonunion: diagnosis and treatment. Orthop Rev 23:861–871

    PubMed  CAS  Google Scholar 

  10. Mathoulin C, Haerle M (1998) Vascularized bone graft from the palmar carpal artery for treatment of scaphoid nonunion. J Hand Surg [Br] 23-B(3):318–323

    Article  Google Scholar 

  11. Mathoulin C, Haerle M, Vandeputte G (2005) Vascularized bone graft in carpal bone reconstruction. Ann Chir Plast Esthet 50(1):43–48

    Article  PubMed  CAS  Google Scholar 

  12. Merrell GA, Wolfe SW, Slade JF III (2002) Treatment of scaphoid nonunions: quantitative meta-analysis of the literature. J Hand Surg [Am] 27-A(4):685–691

    Article  Google Scholar 

  13. Milliez PY, Martin E, El Ayoubi L, Auquit-auckbur I, Beccari R, Biga N (2003) Arthrodèses scapho-lunaires. Ann Orthop Ouest 35:35–40

    Google Scholar 

  14. Pao VS, Chang J (2003) Scaphoid nonunion: diagnosis and treatment. Plast Reconstr Surg 112(6):1666–1675

    Article  PubMed  Google Scholar 

  15. Pistré V, Réau AF, Pélissier P, Martin D, Baudet J (2001) Vascularized bone pedicle grafts of the hand and wrist: literature review and new donor sites. Chir Main 20(4):263–271

    Article  PubMed  Google Scholar 

  16. Roux JL (2003) Vascularized bone transfers in the wrist and hand. Chir Main 22(4):173–185

    Article  PubMed  CAS  Google Scholar 

  17. Sheetz KK, Bishop AT (1995) The arterial blood supply of the distal radius and ulna and its potential use in vascularized bone grafts. J. Hand Surg [Am] 20-A(6):902–914

    Article  Google Scholar 

  18. Shin AY, Bishop AT (2001) Vascular anatomy of the distal radius: implications for vascularized bone grafts. Clin Orthop 383:60–73

    Article  PubMed  Google Scholar 

  19. Sunagawa T, Bishop AT, Muramatsu K (2000) Role of conventional and vascularized bone grafts in scaphoid nonunion with avascular necrosis: a canine experimental study. J Hand Surg [Am] 25-A(5):849–859

    Article  Google Scholar 

  20. Watson HK, Ballet FL (1984) The SLAC wrist: scapholunate advanced collapse pattern of degenerative arthritis. J Hand Surg [Am] 9-A(3):358–365

    Google Scholar 

  21. Watson HK, Pitts EC (1992) Scapholunate dissociation: treatment by triscaphe arthrodesis. Tech Orthop 7:30–34

    Article  Google Scholar 

  22. Watson HK, Weinzweig J, Zeppieri J (1997) The natural progression of scaphoid instability. Hand Clin 13(1):39–49

    PubMed  CAS  Google Scholar 

  23. Zafra M, Carpintero P, Cansino D (2004) Osteonecrosis of the trapezium treated with a vascularized distal radius bone graft. J Hand Surg [Am] 29-A(6):1098–1101

    Article  Google Scholar 

  24. Zaidemberg C (1991) A new vascularized bone graft for scaphoid non-union. J Hand Surg [Am] 16-A(3):474–478

    Google Scholar 

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Authors and Affiliations

  1. Department of Orthopedics and Plastic Surgery, Rouen University Hospital, 1, rue de Germont, Rouen, 76000, France

    F. Mouilhade, I. Auquit-Auckbur, F. Duparc, R. Beccari, N. Biga & P.-Y. Milliez

  2. Anatomy Laboratory, Rouen University Hospital, Rouen, France

    F. Duparc

Authors
  1. F. Mouilhade
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  2. I. Auquit-Auckbur
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  3. F. Duparc
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  4. R. Beccari
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  5. N. Biga
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  6. P.-Y. Milliez
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Correspondence to F. Mouilhade.

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Mouilhade, F., Auquit-Auckbur, I., Duparc, F. et al. Anatomical comparative study of two vascularized bone grafts for the wrist. Surg Radiol Anat 29, 15–20 (2007). https://doi.org/10.1007/s00276-006-0164-2

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  • DOI: https://doi.org/10.1007/s00276-006-0164-2

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