Vascularized Bone Graft from the Second Metacarpal Base to Pathological Fracture of the Carpal Scaphoid through Interosseous Ganglion -A Case Report-

Abstract

The author reports a case of pathological fracture due to intraosseous ganglion at the carpal scaphoid. A 53-year-old female presented with intermittent pain in her left wrist. Her symptoms had been present for 2 years without prior trauma. Plain radiography and computed tomography demonstrated a well-demarcated cyst in the proximal one-third of the scaphoid associated with peripheral fracture. For surgical treatment, the proximal one-third of the scaphoid was visualized through the dorsal approach. The scaphoid exhibited an egg-shell-like appearance and jelly-like fluid was found during curettage of the lesion. The free bone tip from the radial styloid process and vascularized bone graft（size, 7×6×6 mm）pedicled on the dorsal intercarpal artery from the second metacarpal base were rigidly secured at the curetted region. Postoperatively, her wrist was immobilized in a cast for 2 months. At 6 months, she successfully returned to work. Postoperative radiography and computed tomography at 6 months revealed sufficient healing at the proximal scaphoid.