ABSTRACT
Introduction: Scaphoid fractures are not very common and frequently remain undiagnosed, presenting
in non-union and persistent wrist pain. Options for scaphoid fracture treatment have
been described over several decades, however, none with an optimal solution to achieve
union along with good hand function. We describe here, the use of vascularised corticoperiosteal
bone grafts from the medial femoral condyle (MFC) as a solution for the difficult
problem of scaphoid fracture non-union. Materials and Methods: This series has 11 patients with non-union following a scaphoid fracture treated
over 18 months ranging from January 2014 to January 2016 using a vascularised corticoperiosteal
graft from the MFC. Bone graft fixation was done using K-wires and anastomosis was
done with the radial vessels. Results: There were no cases of flap loss. Time of union was an average 3 months. All patients
had a full range of movements. Discussion: MFC is an ideal site for harvesting vascularised corticoperiosteal grafts providing
a large surface of tissue supplied by a rich periosteal plexus from the descending
genicular artery. No significant donor site morbidities have been reported in any
series in the past. The well-defined anatomy helps in a rather simple dissection.
Corticoperiosteal grafts have a high osteogenic potential and hence, this vascularised
graft seems ideal for small bone non-unions. Conclusion: Thin, pliable and highly vascularised corticocancellous grafts can be obtained from
the MFC as an optimal treatment option for scaphoid non-unions.
KEY WORDS
Corticoperiosteal grafts - medial femoral condyle - non-union
