Abstract: Introduction: Nonunion rate is especially high in proximal pole fractures of the scaphoid due to tenuous retrograde blood supply and is a challenging situation for Orthopaedic surgeons. Pronator quadratus pedicled vascularized bone graft is an option for the treatment of scaphoid non-unions. The aim of this study was to evaluate the clinical results of the treatment of scaphoid non-unions using a pronator quadratus pedicled bone graft.
Materials and Methods: In this study a total of 12 patients with non-united scaphoid fractures and were treated with pronator quadratus pedicled bone graft, Herbert-screw and K- wire were enrolled. Clinical outcomes were assessed using the modified Mayo Wrist Score and Disabilities of Arm, Shoulder and Hand score.
Results: All the patients achieved bony consolidation after an average of 8.9 (range 6 to 12) weeks. The range of motion of the affected wrist averaged 60 degrees of flexion, 61 degrees of extension, 14 degrees of radial deviation and 24 degrees of ulnar deviation compared with non-affected wrist, an average of 71 degrees of flexion, 67 degrees of extension, 16 degrees of radial deviation and 30 degrees of ulnar deviation. The evaluation of the grip strength showed an average of 38 kilograms-force on the operated site compared with an average of 42 kilograms- force on the contralateral site.
Conclusion: Pronator quadratus pedicled bone grafting is proved to be effective for bone union, increased wrist joint motion.
