Abstract
The purpose of this study was to examine the outcomes of vascularized bone grafts ( VBGs ) from the distal radius with external fixation for the treatment of Preiser’s disease.
Two patients with Preiser’s disease who underwent VBG surgery based on the 1, 2 intercompart-mental supraretinacular artery were placed in an external fixator for 10 weeks after grafting. Diagnosis was based on radiographic findings of sclerosis, fragmentation, and scaphoid collapse in the absence of any clear antecedent trauma. Both patients underwent preoperative magnetic resonance imaging ( MRI ) scans that confirmed the diagnosis of avascular necrosis of the scaphoid. Postoperative evaluations included a pain evaluation ( visual analogue scale ), X-ray, MRI, disability of the arm, shoulder, and hand ( DASH ) evaluation, and modified Mayo wrist scoring.
A 53-year-old woman was classified as having Herbert stage 3 and Kalainov type 1 disease, and a 67-year-old woman was classified as having Herbert stage 4 and Kalainov type 2 disease. Both patients showed evidence of revascularization, with improvements on T1 and T2 MRI ; however, incomplete revascularization of the entire proximal pole was observed in the 67-year-old patient. In both cases, the clinical results were satisfactory ( modified Mayo wrist scores of 95 and 80 points, respectively ).
VBGs are an efficacious treatment for Preiser’s disease and are thus a recommended surgical treatment.
