Treatment of Scaphoid Nonunions Using a Pronator Quadratus Pedicled Bone Graft

Jang,  Mun Suk; Seo,  Yu Seok

doi:2012.17.4.159

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Arch Hand Microsurg > Volume 17(4); 2012 > Article

Original Article

Journal of the Korean Society for Surgery of the Hand 2012;17(4):159-165.
Published online December 30, 2012.
DOI: https://doi.org/10.12790/jkssh.2012.17.4.159

Treatment of Scaphoid Nonunions Using a Pronator Quadratus Pedicled Bone Graft

Mun Suk Jang, Yu Seok Seo

¹Republic of Korea Air Force l8st Fighter Wing Medical Center, Gangneung, Korea. jjangdol13@hanmail.net
²Department of Orthopedic Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea.

Received: 25 August 2012 • Revised: 4 November 2012 • Accepted: 19 November 2012

Abstract

Purpose
This study was to evaluate the clinical results of the treatment of scaphoid nonunions using a pronator quadratus pedicled bone graft.

Methods
Thirteen patients with a scaphoid nonunion were treated with pronator quadratus pedicled bone graft. The average age of the patients was 20.23 years (range: 19-22 years) and the minimum follow-up period was one year. In all patients, bone grafting was performed and screw was fixed by using a volar aspect of distal radius bone graft with pronator quadratus muscle.

Results
All 13 patients showed radiographic union with the average union time of 10.8 weeks (range: 9-13 weeks). Flexion, extension, radial deviation and ulnar deviation of wrist joint improved compared to the preoperative condition (p<0.05). Postoperative scapholunate and radiolunate angle improved compared to the preoperative condition (p<0.05). Eleven patients (84.5%) showed excellent or good results according to Herbert and Fisher's score criteria of functional, subjective satisfaction and radiographic result.

Conclusion
Pronator quadratus pedicled bone grafting can be considered to be easily accessible technique on vascularized bone graft for osteosynthesis of scaphoid nonunions. It is proved to be effective for bone union, increased wrist joint motion.

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