Vascularized Medial Femoral Condyle Corticoperiosteal Graft for Scaphoid Nonunion

Abstract

Although the vascularized medial femoral condyle corticoperiosteal graft（V-MFCG) is useful for difficult scaphoid nonunion, its usefulness and indications are controversial. We report a small case series of V-MFCG in comparison with conventional bone grafting for scaphoid nonunion.
We treated three difficult scaphoid nonunion cases using V-MFCG. The results were compared with those of six cases of conventional bone grafting for scaphoid nonunion. Bone healing was evaluated by X-ray and computed tomography（CT). We measured the operation time, and postoperative functions were evaluated by range of motion（ROM), ROM improvement rate, symptoms, and Mayo Wrist Score.
The operation time for V-MFCG was approximately twice that for conventional bone grafting. Bone union was achieved in all cases of V-MFCG, whereas bone union was not achieved in two cases of conventional bone grafting. The improvement rate for ROM and postoperative symptoms were significantly higher with V-MFCG than with conventional grafting.
V-MFCG provides relatively good results even in difficult scaphoid nonunion cases, although it is technically more difficult than conventional grafting.